37例乳腺癌肉瘤的临床特征及预后分析  

Clinical characteristics and survival analysis of 37 cases of breast carcinosarcoma

作　　者：吴超[1] 李彦昕[2] 彭菲[1] 徐文婷[1] 刘君[1] 

机构地区：[1]天津医科大学肿瘤医院乳腺二科国家肿瘤临床医学研究中心天津市"肿瘤防治"重点实验室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,300060 [2]内蒙古自治区通辽市医院西区肿瘤外科

出　　处：《中华普通外科杂志》2016年第1期36-39,共4页Chinese Journal of General Surgery

摘　　要：目的探讨乳腺癌肉瘤患者的临床特征和预后的影响因素。方法回顾性分析1974--2014年确诊的37例乳腺癌肉瘤患者的临床资料，采用Kaplan-Meier法计算生存率及进行单因素生存分析，采用COX比例风险模型进行多因素生存分析。结果37例患者均为女性，中位年龄为55岁。全组37例患者中，表现为无痛性肿块31例，乳腺肿块伴局部皮肤破溃者6例。三阴性乳腺癌21例。伴腋窝淋巴结转移10例，发生远处转移10例。37例患者的5年生存率为62．3％。单因素分析结果显示，腋窝淋巴结转移（P=0．045）和治疗方案（P=0．016）为患者预后的影响因素；多因素分析结果显示，治疗方案是影响患者预后的独立危险因素（P=0．041）。结论乳腺癌肉瘤临床罕见，预后较差，雌激素受体、孕激素受体和人表皮生长因子受体2多呈阴性表达。腋窝淋巴结转移者预后较差，合理的综合治疗可以明显改善患者预后。Objective To explore the clinical characteristics and prognostic factors of breast carcinosarcoma. Methods Clinical data of 37 breast carcinosarcoma patients treated at Tianjin Cancer Hospital from 1974 to 2014 was analyzed retrospectively. Kaplan-Meier unvariate analysis was used to calculate the survival rate and compare the survival rates. Multivariate factors for survival were analyzed by COX proportional hazards regression model. Results 37 cases of breast carcinosarcoma were all female. The median age was 55 years. Among them 31 cases complained for painless mass, six cases had breast mass with skin ulceration. 21 cases were three-negative breast cancer. Ten cases had axillary lymph node metastasis, ten cases had distant metastasis. The 5-year survival rate was 62. 3%. Unvariate analysis showed that axillary lymphnodes metastasis （ P = 0. 045 ） and therapeutic schedule （ P = 0. 016） significantly influenced the outcome of the patients. COX multivariate analysis validated that the therapy modality was an independent prognostic factor for breast carcinosarcoma（P = 0. 041 ）. Conclusions Breast is rare and has a poor prognosis. ER, PR and HER-2 expressions in most cases are negative. If there is axillary lymph node metastasis, the prognosis is poor. A reasonable and comprehensive treatment can improve the prognosis.

关 键 词：乳腺肿瘤 癌肉瘤 预后 

分 类 号：R737.9[医药卫生—肿瘤]