2342例乳腺癌患者临床病理学特征及预后分析

  目的  分析可手术的浸润性乳腺癌患者临床及病理学资料, 探讨其预后的影响因素。  方法  收集2002年1月至2004年12月间天津医科大学附属肿瘤医院收治的2 342例可手术的浸润性乳腺癌患者的临床病理学资料, 回顾性分析其临床病理学特征、复发转移及生存情况, 并利用诺丁汉预后指数(Nottingham Prognostic Index, NPI)进行预后生存分析。  结果  2342例乳腺癌患者平均年龄为51.56岁。临床分期Ⅰ、Ⅱ、Ⅲ期分别为571例(24.38%), 1143例(48.8%), 628例(26.82%)。NPI评分低、中、高危组分别为521例(22.25%)、1151例(49.15%)、670例(28.6%)。ER阳性1271例(54.3%), 阴性1071例(45.7%)。PR阳性1698例(72.5%), 阴性644例(27.5%)。C-erbB-2阳性787例(33.6%), 阴性1 555例(66.4%)。单因素分析结果显示, 影响患者5年无瘤生存期(disease-free survival, DFS)及总生存期(overall survival, OS)的因素包括: 临床分期、肿瘤大小、淋巴结状态、组织学分级、家族史、NPI评分、ER、PR及C-erbB-2状态。另外年龄也是影响5年DFS的因素之一。多因素分析结果显示, 影响5年DFS及OS的因素包括: NPI评分、ER、PR及C-erbB-2。  结论  本研究通过分析大宗可手术的浸润性乳腺癌患者临床病理学资料, 证实NPI评分、ER、PR及C-erbB-2为判断浸润性乳腺癌预后较好的临床病理学指标。 

Clinical Features and Multivariate Cox Regression Prognostic Analysis of Operable Breast Cancer: A Report of 2 342 Cases

  Objective  The present paper aims to analyze the clinicopathologic data of patients with operable infiltrating breast cancer and investigates the factors that influence breast cancer prognosis.  Methods  The clinical data of 2342 cases with operable infiltrating breast cancer treated in the Medical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China from January 2002 to December 2004 were collected.The clinicopathologic characteristics of the cancer, recurrence and metastasis, and patient survival rate were retrospectively analyzed.The Nottingham prognostic index(NPI) was used to analyze their prognostic survivals.  Results  The average age of patients was 51.56 years.The cases at clinical stagesⅠ, Ⅱ, andⅢaccounted for 24.38%(571), 48.8%(1143), and 26.82%(628) of patients, respectively.The cases with an NPI score of low, average, and high-risk recurrence respectively accounted for 22.25%(521), 49.15%(1151), and 28.6%(670) of patients.The estrogen receptor(ER) positive, progesterone receptor(PR) positive, and C-erbB-2 over-expression of the tumors were 54.3%(1271), 72.5%(1698), and 33.6% (787), respectively.The univariate analysis revealed that the prognostic factors affecting the 5-year disease-free survival(DFS) and overall survival(OS) included clinical staging, tumor size, lymph node status, histological grading, family history, NPI, ER, PR, and C-erbB-2 status.Moreover, age also affected the 5-year DFS.The multivariate Cox regression analysis showed that the prognostic factors that influence DFS and OS were the NPI, ER, PR, and C-erbB-2 states.  Conclusion  Analysis of the clinicopathologic data of a large number of cases with operable breast cancer confirmed that NPI, ER, PR, and C-erbB-2 status were preferable indicators for breast cancer prognosis.