乳腺癌手术10年后发生肺转移36例临床分析  

Lung metastasis of breast cancer 10 years after operation: A clinical analysis of 36 cases

作　　者：杨冰[1] 张明月[1] 薛新颖[1] 张丽娜[1] 奥婷 汪建新[1] 

机构地区：[1]解放军总医院呼吸科,北京100853

出　　处：《解放军医学院学报》2014年第6期571-574,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的 探讨乳腺癌手术10年后发生肺转移的临床特点,治疗方法和预后相关因素.方法 收集我院1997-2013年乳腺癌手术10年后发生肺转移患者的临床资料,回顾性分析其临床特点（症状和体征）、诊断、鉴别诊断、治疗方法和预后.结果 36例患者中位年龄为55岁,肺转移发生平均时间为（14.27±2.16）年.乳腺癌手术10年后发生肺转移在年龄、肿瘤病理类型、腋窝淋巴结转移、孕激素受体（progesterone receptor,PR）表达、术后化疗方案、术后放疗方面差异无统计学意义（P＞0.05）,但在术前临床分期、雌激素受体（estrogen receptor,ER）表达及内分泌治疗方面差异有统计学意义沪（P＜0.05）.肺转移后中位总生存期为22.5（5～ 79）个月,中位至进展时间为11（3～77）个月.合并其他部位转移,肺转移瘤的数目和最大直径、肺转移后化疗周期数等均与患者的预后相关（P＜0.05）.对6例单发肺转移灶手术切除治疗（R0）,术后中位总生存期为53.4（24 ～ 79）个月,中位至进展时间为42（21 ～ 77）个月.结论 乳腺癌手术10年后发生肺转移患者的预后与转移瘤的数目、大小及治疗方法等因素密切相关.早期诊断,综合运用化疗、放疗、手术、内分泌等治疗有较好的效果.Objective To study the clinical features,diagnosis,treatment and prognosis-related factors of breast cancer lung metastasis 10 years after operation.Methods Clinical data （clinical features,diagnosis,differential diagnosis,treatment and prognosis） about breast cancer lung metastasis patients who underwent operation from 1997 to 2013 were retrospectively analyzed.Results The median age of 36 breast cancer lung metastasis patients was 55,the average lung metastasis time was （14.27 ± 2.16） years.No significant difference was found in the age of breast cancer lung metastasis patients,and tumor pathologic type,axillary lymph node metastasis,progesterone receptor （PR） expression in breast cancer lung metastasis patients,postoperative chemotherapy and radiotherapy plan for breast cancer lung metastasis patients 10 years after operation （P 〉 0.05）.However,the preoperative clinical staging of breast cancer lung metastasis,estrogen receptor （ER） expression in breast cancer lung metastasis patients,and endocrine therapy for breast cancer lung metastasis patients were significantly significant （P 〈 0.05）.The median overall survival time of the patients was 22.5 （5-79） months,and the median time to progression was 11 （3-77） months.Metastasis to other sites,the number of pulmonary metastatic tumors,maximum diameter and chemotherapy cycles of metastatic tumor were related with the prognosis of breast cancer lung metastasis patients （P 〈 0.05）.The overall survival time was 53.4 （24-79） months and the median time to progression was 42 （21-77） months in 6 patients with single focal pulmonary metastasis after surgical resection.Conclusion The prognosis of breast cancer lung metastases 10 years after operation is closely related with the number,size and treatment modalities of metastatic breast cancer.Its early diagnosis,comprehensive chemotherapy,radiotherapy,surgical and endocrine treatment can achieve rather good effects.

关 键 词：乳腺肿瘤 肿瘤转移 肺 

分 类 号：R737.9[医药卫生—肿瘤]