乳腺癌复发转移影响因素的病例对照研究  

A case- control study on the risk factors of recurrence and metastasis in breast cancer

作　　者：张立力[1] 刘翠婷[1] 

机构地区：[1]南方医科大学护理学院,广州510515

出　　处：《中国实用护理杂志》2015年第11期795-799,共5页Chinese Journal of Practical Nursing

基　　金：广东省科技计划项目（2012B031800151）

摘　　要：目的探讨乳腺癌术后复发转移的影响因素，为确定乳腺癌复发转移高危人群的筛检与随访指标提供科学依据。方法采用病例对照研究，2004年1月至2010年12月在广州市南方医院经病理确诊乳腺癌的生存病例，根据纳入标准分为病例组与对照组进行调查，采用非条件Logistic回归分析。结果多因素分析结果显示，精神刺激【OR=10．926，95％CI（5．041～23．682）】、口服避孕药服用史【OR=2．634，95％CI（1．548～4．482）】、乳房良性疾病史【OR=5．183，95％CI（2．100～12．790）】、人表皮生长因子受体-2（HER2）阳性【OR=2．257，95％CI（1．326～3．843）】、腋窝淋巴结转移【OR=2．021，95％CI（1．272—3．212）】、远处转移【OR=3．718，95％CI（2．125～6．503）】可能是乳腺癌术后复发转移的危险因素。而定期运动【OR=0．460，95％CI（0．234～0．905）】、疾病分期低【OR=0．106，95％CI（0．022～0．498）】、母乳喂养时间长【OR=O．053，95％CI（0．009—0．316）】、高大豆异黄酮摄入量【OR=0．154，95％CI（0．032～0．745）】则降低乳腺癌术后复发转移风险。结论对有良性乳腺疾病史的乳腺癌患者加强关注，做到及时复查、早发现、早期诊断、早期治疗，同时提高身体与心理素质，减少口服避孕药、延长母乳喂养时间、增加豆类食品的摄入量对预防乳腺癌术后复发转移具有重要的作用。Objective To explore the risk factors of breast cancer recurrence for the cause explo- ration and prevention of the disease. Methods With matched case-control method, a survey was conducted among survival cases of histologically diagnosed breast cancer patients in Southern hospital from January 2004 to December 2007 in Guangzhou city. The survival cases were divided into case group and control group according to the inclusion criteria. Unconditional logistic model was used to analyze the data. Results Multiple factors logistic regression analysis showed mental stimulations [ OR =10.926, 95%CI （5.041-23.682） ], oral contraceptive pills history [ OR=2.634, 95%CI（1.548-4.482） ], benign breast disease history [ OR=5.183, 95%CI（2.100-12.790） ], human epiderma growth factor receptor-2 （HER2） positive [ OR= 2.257, 95%CI （1.326-3.843） ], lymph node metastasis [ OR=2.021, 95%CI （1.272-3.212） ], distant metastasis [ OR=3.718, 95%CI （2.125-6.503） ] might be associated with the increasing breast cancer recurrence risk. Regular exercise [ OR=0.460, 95%CI（0.234-0.905） ], low stage of disease [ OR=0.106, 95%CI（0.022-0.498） ], breast nursing time [ OR=0.053, 95%CI（0.009-0.316） ], dietary intake of soy isilavones[OR=0.154, 95%CI （0.032-0.745） ] might be associated with the decreasing breast cancer recurrence risk. Conclusions Clinical medical staff should take attention to the breast cancer who had benign breast disease history to ensure timely check-ups, early detection, early diagnosis and early treatment. Improving physical and psychological quality, reducing oral contraceptive pills, prolonging breast nursing time, and increasing dietary intake of soy isflavones were important to the prevention of breast cancer recurrence.

关 键 词：乳腺肿瘤 复发 危险因素 病例对照研究 

分 类 号：R737.9[医药卫生—肿瘤]