术后妊娠对年轻乳腺癌患者预后的影响  

Effect of postoperative pregnancy upon prognosis of young breast cancer patients

作　　者：吴佳毅[1] 陈灿铭[1] 张家新[1] 侯意枫[1] 胡震[1] 柳光宇[1] 狄根红[1] 吴炅[1] 陆劲松[1] 沈坤炜[2] 邵志敏[1] 沈镇宙[1] 

机构地区：[1]复旦大学附属肿瘤医院乳腺外科, 上海200032 [2]上海交通大学医学院附属瑞金医院乳腺疾病诊治中心

出　　处：《中华医学杂志》2009年第44期3126-3129,共4页National Medical Journal of China

摘　　要：目的评估术后妊娠对中国年轻女性乳腺癌患者预后的影响。方法对1989年3月至2007年7月于我院治疗的432例年轻（≤35岁）单侧乳腺癌患者进行回顾性研究，分析术后妊娠对预后的影响，，干jKaplan—Meier法进行生存分析，LogRank法比较不同患者的生存差异，用Cox回归分析对患者进行多因素回归分析。结果432例年轻乳腺癌患者中共有18例术后妊娠，其中5例足月产，13例流产，最早妊娠的时间为术后17个月。中位随访62个月（6～237个月），432例患者的无病生存率（DFS）为72．5％（313／432），总体生存率（0s）为88．7％（383／432）。Cox回归多因素分析发现术后妊娠、临床分期及病理腋窝淋巴结转移数对患者的DFS有显著影响，只有淋巴结转移数对患者的OS有显著影响。由于术后妊娠的患者中并未出现死亡，Cox回归分析中术后妊娠对预后并无显著影响。结论年轻乳腺癌患者手术后妊娠对预后无不良影响。Objective To examine the effect of postoperative pregnancy upon the prognosis of young Chinese breast cancer patients. Methods Four hundred and thirty-two female unilateral breast cancer patients aged 35 or younger were retrospectively reviewed. Kaplan-Meier analysis and Log Rank test were used for univariate analysis of factors predictive of disease-free survival （DFS） and overall survival （OS）. Multivariate analysis was carried out using the Cox proportional hazards model. Results Eighteen patients were identified to have postoperative pregnancy, including 5 full-term pregnancy and 13 abortions with the earliest pregnancy taking place at Month 17 post-operation. After a median follow-up of 62 months （6 -237 months）, the DFS and OS rates were 72. 5% （313/432） and 88.7% （383/432） respectively. On multivariate analysis, postoperative pregnancy, clinical stage and number of pathologically involved axillary lymph node were significantly associated with DFS. And the axillary lymph node status was also predictive of OS. No death occurred in patient with postoperative pregnancy. There was no significant association between postoperative pregnancy and OS. Condusion Postoperative pregnancy has no adverse effect upon the prognosis of young breast cancer patients.

关 键 词：乳腺肿瘤 妊娠 预后 年轻 

分 类 号：R686[医药卫生—骨科学]