T_1N_0M_0乳腺癌临床病理特征和预后分析  

Clinicopathological characteristics and prognosis of breast cancer T_1N_0M_0

作　　者：王永南[1,2] 王颀[1,2] 张安秦[1,2] 李文萍[1,2] 陈中扬[1,2] 万舰[1,2] 罗懿忠[1,2] 韩晓蓉[1,2] 许娟[1,2] 

机构地区：[1]广东省妇幼保健院 [2]广州医学院附属广东省妇儿医院乳腺病防治中心,广东广州511400

出　　处：《中华肿瘤防治杂志》2014年第12期940-944,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨T1N0M0乳腺癌患者的临床病理特征与预后关系。方法:收集2003-01-01-2009-12-31广东省妇幼保健院乳腺病防治中心住院治疗的137例T1N0M0乳腺癌患者的资料,回顾性分析临床病理特征与预后的关系。结果:共收治934例Ⅰ~ⅢA期乳腺癌患者,其中T1N0M0乳腺癌137例,占14.7%。137例T1N0M0乳腺癌患者中有33例(24.1%)为T1mic,42例(30.7%)为T1a^T1b,62例(45.2%)为T1c。肿瘤大小与组织学分级(P=0.001)有关,与年龄(P=0.526)、ER/PR(P=0.371)、HER-2(P=0.624)、手术方式(P=0.479)和术后辅助化疗(P=0.066)无明显相关性。中位随访47个月,5例患者复发转移,其中1例患者死于肝转移,5年无病生存期(disease-free survival,DFS)为96.4%,5年总生存期(overall survival,OS)为99.3%。在单因素分析中,T1N0M0乳腺癌的5年DFS与肿瘤组织学分级(P=0.010)和ER/PR状态(P=0.043)有关,而与年龄(P=0.217)、肿瘤大小(P=0.880)、HER-2状态(P=0.769)、手术方式(P=0.477)和有无化疗(P=0.560)无关;在多因素分析中,仅肿瘤组织学分级是5年DFS的独立影响因素,P=0.045。组织学分级G1、G2和G3患者的5年DFS分别为100.0%、96.3%和84.2%,伴有组织学分级非G3患者的5年DFS(98.3%)优于伴有组织学分级G3(84.2%)的患者,P=0.005;G2(96.3%)和G1(100.0%)患者5年DFS差异无统计学意义,P=0.109。结论:肿瘤组织学分级是T1N0M0乳腺癌的5年DFS独立影响因素,肿瘤组织学分级高的患者预后差。肿瘤组织学分级可为T1N0M0乳腺癌的辅助化疗决策提供参考依据。OBJECTIVE： To investigate the relationship between clinicopathological characteristics and prognosis of T1N0M0patients with breast cancer. METHODS： Collectting the data of 137 cases of hospitalized TI No Mc, patients with breast cancer between 1st January 2003 and 31st December 2009, and retrospectively analyzing the relationship between the clinieopathological characteristics and prognosis. RESULTS： Totally 934 stage I-ⅢA breast cancer patients cases were treated,and breast cancer T1 No M0 137 cases, accounting for 14. 7 %. In 137 cases, 33 cases （24. 1%） were T1mic, 54 cases（30. 7%） for T1a-T1b ,62 cases（45.2%） were T1c. Tumor size and histological grade （P= 0. 001 ） related with age （P=0. 526） ,the status of ER/PR （P=0. 371） ,HER-2 （P=0. 624） and surgical approach （P=0. 479）. There was no significant correlation with adjuvant chemotherapy （P= 0. 066）. Median follow-up was 47 months with 5 patients recurrence,one patient died of liver metastases. S-year disease free survival（DFS） was 96.4% ,S-year overall survival（OS） was 99.3%. In univariate analysis,5 years DFS was related to tumor histological grade（P 0. 010） and ER/PR status（P= 0. 043） ,but not related to age （P=0. 217） ,tumor size （P=0. 880） ,HER 2 status （P=0. 769） ,surgical approach （P= 0. 477） and with or without chemotherapy （P=0. 560）. In the multivariate analysis,independent factors of 5 years DFS was tumor histological grade（P=0. 045）. The 5 years DFS of histological G1 and G2 and G3 were 100.0% and 96.3% and 84.2%. The 5 years DFS of histological G3（84.2%） was worse than that of G1 --G2 （98.3%）,P=0. 005 and there wasno difference between G2 （96. 3%） and G1 （ 100. 0 %）, P = 0. 109. CONCLUSIONS： Clinical and pathological features of age,tumor size, HER-2 status, surgical approach, with or without chemotherapy may not affect 5 years DFS of breast cancer T1N0M0, histological grade and ER/PR status may influence 5 years DFS of breast cancerT1N0M0. Histo

关 键 词：乳腺肿瘤 小肿瘤 临床病理特征 预后 回顾性研究 

分 类 号：R737.9[医药卫生—肿瘤]