淋巴结阴性乳腺癌的预后和辅助化疗  

Prognosis and adjuvant 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胸外科

出　　处：《中华外科杂志》1997年第10期580-582,共3页Chinese Journal of Surgery

摘　　要：作者报道了４３９例经手术治疗，病理证实无区域淋巴结转移的单侧原发性乳腺癌，分析了术后辅助化疗对患者预后的影响。按寿命表法计算生存率。结果显示：淋巴结阴性乳腺癌的主要临床预后因素：（１）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＞３ｃｍ时，单纯手术组为７９．８９％，辅助化疗组为９６．０２％（Ｐ＜０．０１），差异有显著意义。（２）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型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，应寻找更强的指标，以决定辅助化疗与否。对肿瘤＞３ｃｍ、ＥＲ阴性者术后辅助化疗能提高生存率，对淋巴结阴性的乳腺癌手术范围可适当缩小，特别是肿瘤＜３ｃｍ时可以更多考虑行乳腺癌改良根治术。The significance of postoperative chemotherapy was studied in 439 cases of unilateral primary breast cancer which were proved histologically with no axillary lymph node metastasis.The survival rate was analyzed by life table method.The prognosis of node negative breast cancer patients was mainly assosiated with tumor size. 10 year survival rate of patients with tumor less than 3cm treated operativel and by operation combined with chemotherapy was 92.60% and 94.13% respectively.If tumor size was larger than 3cm,the ten year survival rate of the patients treated operatived was 79.89%,and that of the patients with combined theropy 96.02%.The prognosis was statistically different between the two groups.As to age,status of menopause,pathologral type,kind of surgery and status of ER,the prognosis of patients treated by combined therapy was better than that of patients treated by operation alone.The postoperative chemotherapy was not significantly beneficial to breast cancer patients with tumor less than 3cm.

关 键 词：乳腺癌 辅助疗法 预后 淋巴结转移 药物疗法 

分 类 号：R737.9[医药卫生—肿瘤]