326例70岁以上女性乳腺癌患者临床病理特征及预后分析

目的目前,乳腺癌患者年龄逐渐趋于高龄化,但仍缺少≥70岁女性乳腺癌患者的临床研究。本研究回顾性分析≥70岁女性乳腺癌患者的临床病理特征及预后情况,探讨≥70岁乳腺癌患者的治疗方案。方法收集2011-01-01-2013-12-01郑州大学附属肿瘤医院收治的≥70岁女性乳腺癌患者326例的临床资料,分析患者临床病理特征、治疗方案及其预后情况,应用无病生存时间(disease-free survival,DFS)、总生存时间(overall survival,OS)进行预后评价。结果326例患者5年OS率为88.65%(289例),5年DFS率为80.67%(263例)。单因素分析结果显示,患者的年龄、TNM分期、组织学分级、腋窝淋巴结转移、PR以及术后内分泌治疗是影响患者5年OS的危险因素(P<0.05);TNM分期(χ^2=5.518,P=0.019)、组织学分级(χ^2=4.479,P=0.034)、腋窝淋巴结转移(χ^2=5.409,P=0.020)、雌激素受体(estrogen receptor,ER)(χ^2=5.885,P=0.015)、孕激素受体(progesterone receptor,PR)(χ^2=7.916,P=0.005)、人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)(χ^2=3.945,P=0.047)、术后化疗(χ^2=4.353,P=0.037)以及内分泌治疗(χ^2=9.087,P=0.003)是影响患者5年DFS的危险因素,而并发症(χ^2=3.001,P=0.083)、肿瘤位置(χ^2=0.612,P=0.736)、手术方式(χ^2=0.821,P=0.365)、术后放疗(χ^2=0.764,P=0.382)与患者5年生存率的关联性无统计学意义。Cox回归分析结果显示,患者年龄、TNM分期、腋窝淋巴结转移、PR、内分泌治疗是影响≥70岁女性乳腺癌患者OS预后的独立预后因素,患者TNM分期、腋窝淋巴结转移、PR和内分泌治疗是影响70≥岁女性乳腺癌患者DFS的独立预后因素,P<0.05。结论患者年龄、TNM分期、淋巴结转移、PR和内分泌治疗是影响≥70岁女性乳腺癌患者的独立预后因素,可以为≥70岁女性乳腺癌患者治疗以及预后提供重要的参考依据。

Clinicopathological characteristics and prognosis of 326 women with breast cancer over 70 years old

OBJECTIVE This study retrospectively analyzed the clinicopathological characteristics and prognosis of breast cancer patients with≥70 years old to explore the treatment of breast cancer over 70 years old.METHODS The clinicopathological and follow-up data of 326 cases of breast cancer patients over 70 years old admitted to our hospital from January 1,2011 to December 1,2013 were collected.The clinicopathological characteristics,treatment plan and prognosis of the elderly breast cancer patients were analyzed.The prognosis,disease-free survival(DFS)and overall survival(OS)were applied.RESULTS The 5-year OS rate of 326 patients was 88.65%(289 cases),and the 5-year DFS rate was 80.67%(263 cases).Single factor analysis of 5-year survival rate of patients over 70 years old showed that age,TNM stage,histological grade,axillary lymph node metastasis,PR and postoperative endocrine therapy were the risk factors for OS in 5 years(P<0.05),TNM stage(χ^2=5.518,P=0.019),histological grade(χ^2=4.479,P=0.034),axillary lymph node metastasis(χ^2=5.409,P=0.020),estrogen receptor(χ^2=5.885,P=0.015),progesterone receptor(χ^2=7.916,P=0.005).Human epidermal growth factor receptor-2(χ^2=3.945,P=0.047),postoperative chemotherapy(χ^2=4.353,P=0.037)and endocrine therapy(χ^2=9.087,P=0.003)were the risk factors for 5-year DFS,There was no statistically significant correlation between comorbidities(χ^2=3.001,P=0.083),tumor location(χ^2=0.612,P=0.736),surgical approach(χ2=0.821,P=0.365),postoperative radiotherapy(χ2=0.764,P=0.382),and patient 5-year survival.Cox regression analysis showed that patients’age,TNM stage,axillary lymph node metastasis,PR and endocrine therapy were independent prognostic factors(P<0.05).CONCLUSION Age,TNM stage,lymph node metastasis,PR and endocrine therapy are the independent prognostic factors of breast cancer patients over 70 years old,which can provide important reference for the treatment and prognosis of breast cancer patients over 70 years old.