老年乳腺癌临床特征预后多因素分析  

Cox multivariate regression analysis on prognosis of elderly patients with breast cancer

作　　者：邱梅清[1] 佟仲生[1] 贾勇圣[1] 董国雷[1] 郝春芳[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：《实用肿瘤杂志》2013年第2期162-166,共5页Journal of Practical Oncology

摘　　要：目的探讨老年乳腺癌患者的临床病理学特征、生存状态及预后的独立影响因素。方法回顾性分析267例老年乳腺癌患者(≥65岁)和1 910例非老年乳腺癌患者(<65岁)的临床病理学特征、复发转移及生存情况。结果老年与非老年乳腺癌患者5年无瘤生存率(disease free survival,DFS)和总生存率(overall survival,OS)比较差异均无统计学意义(P=0.185,P=0.206);老年乳腺癌患者中,Ⅲ期患者12.7%,肿瘤直径>5 cm者4.1%,腋窝淋巴结阳性>4枚者15.0%,组织学分级Ⅲ级患者7.5%,分子亚型Luminal A型60.3%,行乳腺癌根治术者70.4%,术后行辅助化疗50.6%,术后放疗21.0%,以上患者比例与非老年乳腺癌组比较差异均具有统计学意义(均P<0.05)。单因素及多因素分析结果显示分子亚型、肿瘤大小、淋巴结状态、组织学分级、病理类型是影响老年乳腺癌DFS及OS的危险因素。结论老年乳腺癌患者具有特殊的临床特征和独立预后因素,术后化疗及内分泌治疗可延长老年乳腺癌患者的生存期。Objective To analyze the prognostic factors in elderly patients with breast cancer. Methods The clinicopathological features,recurrence, metastasis and survival status of 267 elderly patients with breast cancer and 1 910 non-elderly breast cancer patients were retrospectively analyzed with Cox multivariate regression method. Results There were no differences in 5- year disease-free survival （DFS） and overall survival （OS） rates between elderly breast cancer patients and non-elderly patients （P = 0. 185, P = 0. 206）. Compared to non-elderly patients, 12.7% elderly patients were in clinical stage III ,4.1% had tumor size 〉 5 cm, 15.0% had more than 4 positive lymph nodes,7.5% had histological grade ]U ,60.3% were with positive Luminal A,70.4% received radical mastectomy, 50. 6% received postoperative chemotherapy and 21. 0% received postoperative radiotherapy. Statistically significant differences were observed in all the above aspects （ all P 〈 0.05 ）. Univariate analysis and multivariate Cox regression analysis showed that molecular subtypes, tumor size, lymph node state, histological grade and tumor type were prognostic factors for elderly patients with breast cancer. Postoperative chemotherapy and hormone therapy improved DFS and OS of patients, while adjuvant radiation didn＇t. Conclusions Elderly patients with breast cancer have special clinical characteristics and independent prognostic factors. Postoperative adjuvant chemotherapy and endocrine therapy may improve their survival.

关 键 词：乳腺肿瘤 预后 因素分析 统计学 回顾性研究 

分 类 号：R737.9[医药卫生—肿瘤]