乳腺癌肺转移117例临床病理特征及预后相关因素分析  

Clinical features and prognostic analysis of 117 breast cancer patients with rst metastasis to the lung

作　　者：邱梅清[1] 佟仲生[1] 郝春芳[1] 贾勇圣[1] 刘晓东[1] 

机构地区：[1]天津医科大学附属肿瘤医院乳腺内科,乳腺癌防治教育部重点实验室,天津市"肿瘤防治"重点实验室,天津300060

出　　处：《肿瘤》2012年第11期907-912,918,共7页Tumor

摘　　要：目的:探讨乳腺癌肺转移患者预后相关因素。方法:研究对象为2001年1月-2008年12月共117例可手术乳腺癌首发肺转移患者,收集这些患者的临床病理资料,并进行生存随访。对可能影响乳腺癌肺转移患者预后的因素进行单因素和多因素分析。结果:所有患者肺转移后中位总生存期为32(2～107)个月,中位至进展时间为13(1～76)个月,术后中位总生存期为66(8～169)个月。分子亚型为luminal A、luminal B、HER-2/neu过表达型和三阴性乳腺癌患者肺转移后的5年生存率分别为65.4%、33.2%、30.2%和19.2%(P=0.006);2年无进展生存率分别为64.6%、49.3%、48.0%和30.7%(P=0.005)。单因素分析结果显示,分子亚型、无病间期(disease-free interval,DFI)、肝转移、脑转移、肺转移性肿瘤的数目、肺转移性肿瘤的位置、肺转移性肿瘤最大直径和肺转移后化疗周期数均与乳腺癌肺转移患者的预后相关(P<0.05)。COX多因素分析结果显示,DFI、肺转移性肿瘤的数目、肺转移性肿瘤的位置和肺转移性肿瘤最大直径是乳腺癌肺转移患者的独立预后因素(P<0.05)。结论:乳腺癌肺转移患者的预后与肺转移性肿瘤的情况密切相关。早期发现肺转移对治疗乳腺癌肺转移具有重要意义。Objective： To analyze the prognosis-related factors of breast cancer patients with first metastasis to the lung. Methods： One-hundred and seventeen breast cancer patients with first metastasis to the lung were included in this study from January 2001 through December 2008. All these patients had undergone breast cancer surgery. The clinical and pathological information of the patients was collected. All the patients received a follow-up, and the factors related to the survival were evaluated by using univariate and multivariate analyses. Results： The median overall survival after lung metastases was 32 （2-107） months, the median time to progression was 13 （1-76） months, and the median overall survival after breast cancer surgery was 66 （8-169） months. The five-year survival rates after lung metastases were 65.4%, 33.2%, 30.2% and 19.2%, respectively （P = 0.006） and the two-year progression-free survival rates were 64.6%, 49.3%, 48.0% and 30.7%, respectively （P = 0.005） for four different molecular subtypes which were luminal A, luminal B, HER-2 （human epidermal growth factor receptor 2）/neu overexpression and triple negative. In univariate analysis, the factors of molecular subtypes, disease-free interval, liver metastases, brain metastases, number of lung metastases, location of lung metastases, size of the largest metastasis and cycles of chemotherapy after lung metastases were associated with the prognosis of breast cancer patients with first metastasis to the lung （P 〈 0.05）. In multivariate analysis, the factors of disease-free interval, number of lung metastases, location of lung metastases and size of the largest metastasis were independent predictors of poor survival after lung metastases （P 〈 0.05）. Conclusion：The prognosis of breast cancer patients with first metastasis to the lung is associated with the nature of the lung metastases. The findings of this study suggest that early diagnosis of lung metastases play an important role in the treatment of lung meta

关 键 词：乳腺肿瘤 肺转移 预后 多因素分析 

分 类 号：R737.9[医药卫生—肿瘤]