乳腺癌术后复发风险时间分布规律研究

目的研究我国乳腺癌患者术后复发风险时间分布规律。方法回顾性研究在本院手术治疗并且资料完整的原发性乳腺癌患者共2214例，对其进行生存分析及复发风险分析。结果单因素和多因素生存分析均提示，肿瘤大小、腋下淋巴结转移状态及孕激素受体（PR）状态是无复发生存率的预后因素（P〈0，05）。全组患者年复发风险曲线呈现双峰型，即该复发风险存在两个高峰期，分别位于术后第2年及术后第9．5～10年左右；肿瘤大小、腋下淋巴结转移状态、绝经状态或激素受体状态不同的患者均存在术后双峰型复发模式，但不同亚组间亦存在一定的差异，主要表现为该复发模式在肿瘤较大及淋巴结阳性的亚组中更为明显，以及雌激素受体阳性患者的复发双峰较阴性患者在时间上有所延迟。结论乳腺癌术后复发风险时间分布呈现出一定的规律，针对性制定术后随访和辅助治疗的新策略，可能有助于改善乳腺癌的治疗效果。

Time distribution of recurrence risk for breast cancer patients undergoing surgery

Objective To investigate the time distribution of recurrence risk for breast cancer patients undergoing surgery.Methods A retrospective study of 2 214 female unilateral breast cancer patients undergoing surgery in our hospital was performed.The complete follow-up data were used to analyze the survival and recurrence risk of patients.Results Both univariate and multivariate survival analysis indicated that tumor size,axillary nodal status and progesterone receptor(PR) were prognostic factors for recurrence-free survival(P<0.05).Annual recurrence hazard curve for entire population,as well as various patient subgroups,showed a double-peaked pattern.The analysis according to tumor size and axillary nodal status proved that the double-peaked pattern was almost completely generated by patients with larger tumors and by those with positive lymph nodes.Compared with estrogen receptor(ER)-positive tumors,ER-negative breast cancers were more likely to recur early.Conclusion According to the time distribution of recurrence risk,novel strategies for post-operative treatment and follow-up could be formulated,which provides the possibility to improve the therapeutic effect and reduce the recurrence risk.