天津市近20年女性乳腺癌患者临床病理特点及预后变化趋势分析

目的 比较1981-2000年近20年间不同时期乳腺癌临床病理特点及预后情况,了解其发病和预后变化趋势。方法 从天津医科大学附属肿瘤医院1981-2000年20年间收治的11400例乳腺癌病例中随机抽取1678例,对其临床病理及预后资料进行回顾性分析和比较。结果 1991-2000年（1990年代）和1981-1990年（80年代）相比,收治的乳腺癌病例数增加237％,平均每年上升11．8％;患者发病年龄未见明显变化,中位年龄为46～47岁;早期乳腺癌（0-I期）的检出率提高,由1981-1985年的12％上升到1996-2000年的15．5％,而Ⅲ期乳腺癌的比例明显降低,由24．9％降至16．5％,原位癌比例由3．7％上升到4．4％;同时腋淋巴结转移率和局部复发及远处转移几率降低,分别由51．8％和27．8％下降到46．3％和13．5％;生存分析显示,患者术后5年及10生存率分别从1980年代的76％、63％提高到1990年代的86％和74％。结论 近20年来乳腺癌发病率呈明显上升趋势,早期乳腺癌检出比例增加,腋淋巴结转移率和局部复发及远处转移几率降低,患者预后得到改善,5年、10生存率均有提高。

The trend of clinical characteristics and prognosis of women's breast cancer 1981 - 2000

OBJECTIVE: To investigate the trend of clinical characteristics and prognosis of breast cancer in women during the past 2 decades (1981 - 2000). METHODS: 1678 cases were sampled randomly from the 11400 breast cancer patients who were hospitalized in Tianjin Medical University Cancer Hospital 1981 - 2000. Retrospective analysis of the clinical characteristics and prognosis between different eras was conducted. RESULTS: The numbers of hospitalized female breast cancer patients during the periods 1981 - 1985, 1986 - 1990, 1991 - 1995, 1996 - 2000 were 209, 316, 449, and 704 respectively with an increase of 237% within 20 years and an annual increase rate of 11.8%. The mean onset age remained 46 - 47. The detection rate of breast cancer at early stages (stages 0 approximately I) was 15.5% during 1996 - 2000, higher than that during 1981 - 1985 (12%), and the detection rate of breast cancer at stage III during 1996 - 2000 was 16.5%, lower than that during 1981 - 1985 (24.9%). The proportion of carcinoma in situ during 1996 - 2000 was 4.4%, higher than that during 1981 - 1985 (3.7%). The axillary lymph node positive rate during 1996 - 2000 was 46.3%, lower than that during 1981 - 1985 (51.8%s), and the local recurrence/distance metastasis rate during 1996 - 200 was 13.5%, lower than that during 1981 - 1985 (27.8%). The 5-year and 10-year survival rates during 1996 - 2000 were 86% and 74%, both higher than those during 1981 - 1985 (76% and 63% respectively). CONCLUSION: During the past 2 decades, the incidence of breast cancer shows an uptrend. The proportion of early stage breast cancer increases gradually and the proportion of axillary lymph node positive rate and metastasis rate show a downtrend. The prognosis of the breast cancer patients has been improved during these periods.