腋淋巴结阴性乳腺癌临床病理特征和预后的回顾性分析

目的:分析腋窝淋巴结阴性乳腺癌的临床病理特征及预后的影响因素。方法:收集215例腋窝淋巴结阴性及225例淋巴结阳性乳腺癌患者的临床病理及预后资料,应用χ2检验进行组间比较,以logistic回归进行多因素分析。结果:单因素分析显示,两组间月经状况(P=0.04)、肿瘤大小(P<0.001)、肿瘤分级(P=0.008)、肿瘤位置(P=0.001)差异均有统计学意义。多因素分析显示,肿瘤大小和肿瘤位置是影响淋巴结阴性和阳性乳腺癌患者独立的临床病理因素。两组预后指标分析显示,阴性组有较低的复发率(P<0.001)及远处转移率(P=0.002),有较高的术后生存率(P<0.001)。其中,肿瘤大小(P<0.001)、肿瘤分级(P=0.003)、肿瘤位置(P<0.001)是影响淋巴结阴性乳腺癌患者5年无病生存的因素;肿瘤大小(P=0.012)和肿瘤位置(P<0.001)是影响淋巴结阴性乳腺癌患者5年总生存的因素。结论:淋巴结阴性乳腺癌患者有较好的预后,肿块大小、肿瘤位置是淋巴结阴性乳腺癌患者的独立临床病理因素,也是影响淋巴结阴性乳腺癌患者5年无病生存率及总生存率的预后指标。

Retrospective analysis of clinic pathology features and prognosis analysis of node-negative breast cancer patients

OBJECTIVE: To investigate the clinical pathology features and prognosis analysis in patients with early node-negative breast cancer.METHODS: The data of 440 breast cancer patients were retrospectively reviewed.The patients were divided into the Axillary-node-negative breast cancer group(n=215) and the Axillary-node-positive breast cancer group(n=225).The clinic pathologic and prognosis analysis of the two groups were compared.The data analyzed by χ2 method.Logistic multivariate prognosis analysis was performed.RESULTS: Univariate analysis showed that menses state(P=0.04),tumor size(P<0.001),tumor classification(P=0.008),and tumor place(P=0.001) were clinic pathology features of early node-negative breast cancer different from node-positive breast cancer.Multivariate analysis showed that tumor size an tumor place were independent clinic pathology features of early node-negative breast cancer different from node-positive breast cancer.Prognosis analysis showed that patients with node-negative breast cancer have lower local recurrence rate(P<0.001),distant metastasis rate(P=0.002) and higher survival rates(P<0.001).Tumor size(P<0.001),tumor classification(P=0.003) and tumor place(P<0.001) were prognostic factors of early node-negative breast cancer.Tumor size(P=0.012) and tumor place(P<0.001) were prognostic factors of node-negative breast cancer in 5-year overall survival rate.CONCLUSIONS: Patients with node-negative breast cancer have better prognosis than those with node-positive breast cancer;The tumor size and tumor place are independent clinic pathology features of node-negative breast cancer different from node-positive breast cancer.The tumor size and tumor place are prognostic factors of node-negative breast cancer in 5-year disease-free survival rate and 5-year overall survival rate,too.