获诊时间窗等临床病理因素对三阴性乳腺癌预后的影响  

The influence of diagnostic interval and other clinicopathological factors on the prognosis of triplenegative breast cancer

作　　者：孙矗[1] 李洪涛[1] 刘子梅 袁媛[1] 沈赞[1] 

机构地区：[1]上海交通大学附属第六人民医院肿瘤内科,上海200233

出　　处：《中国癌症杂志》2016年第6期538-545,共8页China Oncology

摘　　要：背景与目的:从症状首次出现到确诊的时间,称为获诊时间窗(diagnostic interval,DI)。三阴性乳腺癌(triple-negative breast cancer,TNBC)常见临床病理指标与DI的关系及DI对TNBC患者预后的影响尚不清楚,将对此进行深入研究。方法:回顾性分析上海市第六人民医院2009年9月—2015年9月收治的83例TNBC患者的资料。对DI等临床病理指标运用Kaplan-Meier法进行单因素分析,对其中差异有统计学意义者采用Cox回归模型进行多因素分析。运用t检验和Kruskal-Wallis检验对DI与常见指标间的关系进行深入研究。结果:DI:T3期>T1期(P=0.01),Ⅲ期>Ⅰ期(P=0.03)、Ⅱ期(P=0.01)。与DI≥3个月组相比,DI<3个月组的平均确诊年龄和TNM分期均较早(P=0.028和0.035)。T分期、N分期、新辅助化疗、TNM分期和DI是总生存时间(overall survival,OS)的影响因素,年龄、T分期、N分期、TNM分期、月经状态和新辅助化疗是无进展生存时间(progression-free survival,PFS)的影响因素,TNM分期是两者的独立影响因素。结论:疾病分期较晚者,DI较长;DI较短者确诊时的疾病分期和年龄均较早;DI是OS的影响因素;TNM分期是OS和PFS的独立影响因素。Background and purpose： The time from first onset of symptoms or signs to a definitive diagnosis is defined as diagnostic interval （DI）. The relation of DI to other clinicopathological parameters and the impact of DI on prognosis of patients with triple-negative breast cancer （TNBC） remain unclear. This article plans to make an intensive study of these questions. Methods： The clinical records of a series of 83 consecutively presenting unselected patients referred to the Shanghai Sixth People＇s Hospital with diagnosed TNBC between September 2009 and September 2015 were retrospectively reviewed. Clinical and pathological factors included were investigated by univariate analysis using the Kaplan-Meier method, the factors associated with prognosis were further evaluated by multivariable analysis with Cox progression model, t-test and Kruskal-Wallis test were used to study the correlation between DI and other characters. Results： DI： stage T3〉T1 （P=0.01）, stage 11I〉 1I （P=0.03） and I （P=0.01）. Compared with patients of DI/〉 3 months, the 〈3 months group had earlier age （P=0.028） and TNM stage （P=0.035）. T stage, N stage, neoadjuvant chemotherapy, TNM stage and DI are influencing factors of overall survival （OS）. Age, T stage, N stage, TNM stage, menstrual status and neoadjuvant chemotherapy are influencing factors of progression-free survival （PFS）. TNM staging is an independent influencing factor for OS and PFS. Conclusion： Patients with later disease stage were more likely to have a longer DI; The shorter DI, the earlier age and stage of disease; DI is the influence factor of OS; TNM stage is an independent influencing factor for OS and PFS.

关 键 词：获诊时间窗 三阴性乳腺癌 生存分析 

分 类 号：R737.9[医药卫生—肿瘤]