65岁以上老年乳腺癌的预后及其影响因素分析  

Prognostic Factors Analysis of Elderly Patients with Breast Cancer

作　　者：徐煜林[1] 周冰[1] 冯红芳[1] 孙金中[1] 涂毅[1] 孙圣荣[1] 

机构地区：[1]武汉大学人民医院乳腺甲状腺外科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2014年第2期249-252,共4页Medical Journal of Wuhan University

基　　金：国家重大科学仪器设备开发专项课题(编号:2012YQ16020306);湖北省自然科学基金资助课题(编号:2011CBD489)

摘　　要：目的:探讨65岁以上老年乳腺癌患者的临床特点、治疗方案,分析其预后影响因素。方法:回顾性分析2006年7月至2012年12月收治的160例老年乳腺癌患者的临床资料,采用Kaplan-Meier法和Cox回归法分析各因素对预后的影响。随访率90.6%,随访时间为11-88个月。结果:全组死亡47例,生存113例。浸润性导管癌占全部患者的79.4%。激素受体阳性患者占56.3%。全组患者1,3,5年总生存率分别为95%,74.1%和56.3%。单因素分析显示,组织学分级、肿瘤大小、淋巴结、TNM分期、激素受体、HER2和内分泌治疗是影响预后的因素,而Cox多因素分析结果显示,组织学分级、肿瘤大小、淋巴结、激素受体和HER2是影响预后的独立因素。结论:老年乳腺癌具有独特的临床和病理特点,影响预后的独立因素是组织学分级、肿瘤大小、淋巴结、激素受体和HER2受体。Objective： To investigate the prognostic iactors ior breast cancer in patients over 65 years old. Methods： The clinicpathological data of 160 old patients with breast cancer were retrospectively analyzed. Kaplan-Meier and Cox regression analyses were used to analyze the relationship between prognostic factors and survival time. The patients were followed up for 11-88 months, and the follow-up rate was 90.6%. Results： In the whole group, 47 patients died and 113 cases were surviving. Major pathological type was invasive ductal carcinoma （79.4%）. Estrogen or progesterone receptors were positively expressed in 56% cases by immunohistochemical staining. The cumulative 1-year, 3-year, and 5-year overall survival was respectively 95%, 74.1% and 56.3%. Kaplan-Meier analysis showed that histological grade, tumor size, lymph node status, clinical stage, hormone receptor, HER2, and endocrine therapy were related with prognosis. Cox multivariate analysis indicated that histological grade, tumor size, lymph node status, hormone receptor, and HER2 were independent prognostic factors. Conclusion： Female breast cancer patients over 65 years of age exhibit distinctive clinical and pathological characteristics. Histological grade, tumor size, lymph node status, hormone receptor, and HER2 are independent prognostic factors.

关 键 词：乳腺癌 老年人 预后 治疗方案 比例危险度模型 

分 类 号：R737.9[医药卫生—肿瘤]