39例男性乳腺癌患者预后因素分析

目的 探讨单一机构一定时间段内收治的男性乳腺癌患者病理特征及其预后分析.方法 整理收集2007年1月1日—2012年1月1日期间就诊于蚌埠医学院第一附属医院的男性乳腺癌病例,回顾性分析其临床特点及病理类型,及其相关因素对患者预后的影响.采用Kaplan-Meier法进行生存率估计,对于组间生存率的比较采用Log-rank检验,同时采用Cox比例风险回归模型进行预后因素的分析.结果 根据单因素分析结果显示,影响男性乳腺癌患者5年无病生存率的因素有:年龄分层(P=0.017)、淋巴结转移情况(P=0.006)、雌激素受体(ER)表达情况(P=0.002)、孕激素受体(PR)表达情况(P=0.003)以及肿瘤大小(P=0.025).年龄分层(P=0.027)、淋巴结转移情况(P=0.022)、ER表达情况(P=0.001)、PR表达情况(P=0.001)以及肿瘤直径大小(P=0.031)是影响男性乳腺癌患者总生存率的因素.根据多因素分析结果,年龄分层(HR=0.197,95.0％置信区间:0.057～0.680,P=0.010)与男性乳腺癌患者无病生存率相关.年龄分层(HR=0.191,95.0％置信区间:0.054～0.680,P=0.011)以及淋巴结转移情况(HR=1.841,95.0％置信区间:0.638～5.308,P=0.049)是男性乳腺癌患者的总生存率影响因素.结论 男性乳腺癌发病率较低,预后较差,在现阶段缺乏有效的治疗手段,提高早期检出率,争取早发现早治疗,是促进其良好预后的一大措施.

Analysis on the prognostic factors of 39 male patients with breast cancer

Objective To investigate the pathological characteristics and prognosis of male breast cancer patients admitted to a single institution for a certain period of time.Methods A retrospective method was adopted in this study to analyze the clinicopathologic fea-tures and survival conditions of 39 cases of male breast cancer patients,who were diagnosed and treated in the first affiliated hospital of Bengbu medical college from January 1 st 2007 to January 1 st 2012.The Kaplan-Meier method was employed to estimate the survival rate.The Log-rank test was adopted to compare the survival between two groups,and the Cox regression model was used to analyze the prognostic factors.Results According to the univariate analysis,the factors affecting the 5-year disease-free survival rate of male pa-tients with breast cancer were age stratification (P =0.017),lymph node metastasis (P =0.006),estrogen receptor expression (P =0.002 ),Progesterone receptor expression (P =0.003)and tumor size (P =0.025).The factors affecting the total productivity of male breast cancer patients were age stratification (P =0.027),lymph node metastasis (P =0.022),estrogen receptor expression (P =0.001 ),progesterone receptor expression (P =0.001 )and tumor diameter (P =0.031 ).According to multivariate analysis,age strati-fication (HR =0.197,95.0％ confidence interval:0.057-0.680,P =0.010)was associated with disease-free productivity in male breast cancer patients.(HR =1 .841 ,95.0％ confidence interval:0.638 (P =0.011 )and lymph node metastasis (HR =1 .841 , 95.0％ confidence interval:0.638-5.308,P =0.049)were the factors affecting the overall productivity of male breast cancer patients. Conclusions Male breast cancer has a low incidence rate and poor prognosis.We can improve the prognosis by improving the positive rate of male breast cancer through early diagnosis and treatment.