腋淋巴结阴性乳腺癌的预后和辅助化疗  

Prognosis and Adjuvent Chemotherapy of Axillary Node negative Breast Cancer Patients

作　　者：韩企夏[1] 沈镇宙[1] 余黎明[1] 袁建达[1] 夏川江[1] 潘天锡[1] 

机构地区：[1]上海医科大学肿瘤医院

出　　处：《齐鲁肿瘤杂志》1997年第1期51-53,共3页

摘　　要：本文分析上海医科大学肿瘤医院外科１９８０年１月至１９９２年１２月，手术治疗单侧原发性乳腺癌４３９例，所有病例均经病理证实无区域淋巴结转移。４３９例中行改良根治术者４３例，根治术１０３例，扩大根治术２９３例，其中单纯手术者１７５例，术后行ＣＭＦ方案辅助化疗者２６４例，两组资料的临床特征相似（Ｐ＜０．０５），有可比性。随访至１９９４年１２月，随访率９７．９５％，资料输入计算机按寿命表法统计生存率。结果显示：淋巴结阴性乳腺癌的主要临床预后因素是肿瘤大小，当肿瘤≤３ｃｍ时，单纯手术组与辅助化疗组的１０年生存率分别为９２．６０％和９４．１３％，肿瘤大于３ｃｍ时，单纯手术组为７９．８９％，辅助化疗组为９６．０２％，有显著意义（Ｐ＜０．０１）。不管年龄、绝经与否、肿瘤病理分型、手术方式和雌激素受体测定等分析均显示辅助化疗组的疗效优于单纯手术组（Ｐ＜０．０５～０．００１）。作者认为对肿瘤≤３ｃｍ的淋巴结阴性乳腺癌的术后辅助化疗的差别不明显，应寻找更多更强的指标，以决定辅助化疗与否，对肿瘤大于３ｃｍ，ＥＲ阴性者术后辅助化疗能提高生存率。We studied 439 cases of unilateral primary breast cancer which were proved histologically with no axillary lymph node metastasis from Jan.1980 to Dec.1992.43 cases received modified mastectomy,103 radical mastectomy,293 extended radical mastectomy.These patients were divived into two groups,one(175 cases) received operation only,the other(269 cases)received operation combined with postoperative chemotherapy(CMF).The clinical charateristics of two groups was not statistically different.All patients were followed up untill Dec.1994,and the follow-up rate was 97.95%.All data were imported into computer and were analysized by life-table method for survive rate.Results showed that the prognosis of node-negative breast cancer patients was mainly assosiated with tumor size.Ten-year survive rate of patients with tumor no larger than 3cm treated by operation alone and by operation combined with chemotherapy was 92.60% and 94.13% respectively.If tumor size was larger than 3cm,the 10-eyear survive rate of former patients was 79.89%,the later 96.02%.The prognosis was statistically different between these two groups.Regardless of age,status of menopause,pathology type,kinds of surgery and status of ER.The prognosis of patients treated by combined therapy was better than that of patients who were treated by operation alone.Our study demonstrated that the postopertive chemotherapy was not significantly beneficial to breast cancer patients with tumor not larger than 3cm.So some stronger clinical parameters should be explored to determine whether these patients should receive postoperative chemotherapy.Postoperative chemotherapy can improve the survival rate of ER-negative patients with tumor larger than 3cm.

关 键 词：淋巴结阴性 预后 乳腺肿瘤 化学疗法 

分 类 号：R737.9[医药卫生—肿瘤]