影响男性乳腺癌预后的多因素分析——单中心72例临床资料总结  

Analysis of prognostic factors in male breast cancer:a report of 72 cases from a single institution

作　　者：周菲菲[1,2] 夏良平[1,2] 王曦[1,3] 郭桂芳[1,2] 戎煜明[1,2] 丘惠娟[1,2] 张蓓[1,2] 

机构地区：[1]华南肿瘤学国家重点实验室,广东广州510060 [2]中山大学肿瘤防治中心综合科,广东广州510060 [3]中山大学肿瘤防治中心乳腺科,广东广州510060

出　　处：《癌症》2010年第2期196-201,共6页Chinese Journal of Cancer

摘　　要：背景与目的:中国男性乳腺癌的报道大多是小样本、回顾性研究,而分析影响患者预后因素的报道极少。本研究在相对比较大样本的中国男性乳腺癌资料基础上探讨影响患者预后的因素。方法:收集1969年1月至2009年3月在中山大学肿瘤防治中心经病理确诊、随访资料齐全的72例男性乳腺癌患者的临床资料。采用Kaplan-Meier方法、log-rank检验和Cox回归模型分析影响男性乳腺癌患者预后的因素。结果:本组男性乳腺癌患者的5年总生存率为72.4%,其中Ⅰ期100%,Ⅱ期74.2%、Ⅲ期57.2%、Ⅳ期0。单因素分析显示,肿瘤大小(P<0.001)、腋窝淋巴结转移(P=0.001)、TNM分期(P=0.001)、手术方式(手术和非手术比较:P<0.001;经典根治术和改良根治术比较:P=0.336)、有无内分泌治疗(P=0.02)是影响男性乳腺癌预后的因素。Cox多因素模型分析显示,TNM分期(P=0.035)、手术与否(P=0.021)、有无内分泌治疗(P=0.019)是影响预后的主要因素。结论:TNM分期、手术与否和有无内分泌治疗是影响中国男性乳腺癌预后的重要因素,提示早期发现和以手术为主、包含有内分泌治疗的综合治疗模式是提高男性乳腺癌患者生存率的关键手段之一。Background and Objective： Male breast cancer （MBC） in China usually has been studied retrospectively with small sample size, and studies analyzing the prognostic factors are rare. This study was to investigate the prognostic factors of Chinese patients with MBC based on the data from a single institute with a relatively large sample. Methods. Clinical data of 72 patients with histopathologically confirmed MBC who received treatment at Sun Yat-sen University Cancer Center between January 1969 and March 2009, were collected. Kaplan-Meier, log-rank test and Cox regression model were used for statistical analysis. Results. The 5-year overall survival rate was 72.4%, and the survival rates for stage I , II , III and IV were 100%, 74.2%, 57.2% and 0%, respectively. Univariate analysis showed that the tumor size （P 〈 0.001）, axillary lymph node status （P= 0.001）, TNM stage （P= 0.001）, operation model （with vs. without, P 〈 0.001 ; classic radical resection vs. modified radical resection, P= 0.336） and endocrine therapy（P = 0.02） significantly influenced the survival. Multivariate Cox regression showed that TNM stage （P= 0.035）, operation model （P= 0.021） and endocrine therapy （P= 0.019） were independent prognostic factors for MBC. Conclusions： Early diagnosis and comprehensive treatment strategy consisting of surgery and endocrine treatment is essential to improve the survival of the patients with MBC, and TNM stage, operation and endocrine treatment are the significant prognostic factors for MBC.

关 键 词：男性乳腺癌 生存率 预后 单因素 多因素 

分 类 号：R737.9[医药卫生—肿瘤] R730.7[医药卫生—临床医学]