男性乳腺癌的临床特点和术后生存质量影响因素分析  

Clinical characteristics of male breast cancer and analysis of influential factors of postoperative quality of life

作　　者：陈达丰[1] 周松[1] 张雪惠[1] 陈月凤[1] 金娥[2] 

机构地区：[1]中国人民解放军第175医院(厦门大学附属东南医院)普通外科,福建漳州363000 [2]中国人民解放军第175医院(厦门大学附属东南医院)肾内科,福建漳州363000

出　　处：《中国实验诊断学》2017年第10期1696-1701,共6页Chinese Journal of Laboratory Diagnosis

摘　　要：目的分析男性乳腺癌的临床特征、手术方式与远期效果,探讨术后生存质量及其影响因素。方法回顾分析我院1995年-2015年收治的45例男性乳腺癌患者的临床病例资料,入组患者均经病理确诊为乳腺癌、资料完整、随访齐全,分析患者的临床表现、病理特征、治疗方式、生活质量、远期疗效,探讨年龄、婚姻、文化程度、家庭收入、费用支付方式、疾病分期对术后生存质量的影响。结果 45例患者中97.78%患者以乳腺肿物为首发症状,70.45%肿物位于乳晕区,79.55%肿块的最大径<5cm,70.45%肿块为不规则形。45例患者均采用以手术为主的综合治疗,64.44%患者接受传统根治术治疗,24.44%患者行改良根治术,4.44%(2/45)患者行新辅助化疗,75.56%(34/45)患者行术后辅助化疗,31.11%患者(14/45)行术后胸壁和区域淋巴引流区辅助放疗,20%(9/45)患者给予内分泌辅助治疗。45例患者均经病理诊断,浸润性导管癌为主要类型,约占82.22%(37/45),TNM临床分期以Ⅱ期为主,约占53.33%(24/45),42例患者采用免疫组化法进行激素受体检测,雌激素受体(ER)阳性率为88.10%(37/42),孕激素受体(PR)阳性率为80.95%(34/42),人类表皮生长因子受体2(HER-2)阳性率为19.05%(8/42)。5年DFS生存率为55.56%(25/45),5年OS总生存率为73.33%(33/45),0期3例,存活率100%(3/3),Ⅰ期8例,存活率100%(8/8),Ⅱ期18例,存活率为75%(18/24),Ⅲ期存活4例,存活率为40%(4/10),不同临床分期5年存活率差异具有统计学意义(χ~2=9.716,P<0.05)。患者术后12个月的FACT-B量表各因子得分及总得分均明显高于术后6个月,差异有统计学意义(P<0.05)。不同年龄阶段、婚姻状况、文化程度、家庭人均月收入和费用支付方式的术后6个月、12个月生活质量评分差异具有统计学意义(均P<0.05)。结论男性乳腺癌多以无痛性乳晕区肿块为首发症状,病理类型多为浸润性导管癌,雌激素受体(ER)、孕激素受体(PR)阳性率�Objective To analyze the clinical characteristics,surgical methods and long-term effects of male breast cancer,and to explore the quality of life and its influencing factors.Methods The clinical data of 45 male with breast cancer patients admitted from our hospital from 1995 to 2015 were analyzed retrospectively.The patients were diagnosed as breast cancer by pathology,which had complete data and complete follow,the clinical manifestations,pathological features,treatment,quality of life,long-term efficacy were analyzed.the influence of age,marriage,educational level,family income,cost payment method and disease stage on postoperative quality of life were explored.Results there were 97.78% patients with Breast mass as first symptom,70.45% patients with Breast mass in areola area,79.55%patients with a Maximum diameter5cm Breast mass,70.45% patients with Irregular shape Breast mass.45 patients were treated with surgery-based comprehensive treatment,64.44% of patients underwent conventional radical mastectomy,24.44% of patients underwent modified radical mastectomy,4.44%（2/45）of patients underwent neoadjuvant chemotherapy,75.56%（34/45）patients underwent postoperative adjuvant chemotherapy,31.11% 45）underwent Chest wall and regional lymphatic drainage area adjuvant radiotherapy postoperative,20%（9/45）patients underwent endocrine adjuvant therapy.45 patients were diagnosed by pathology,invasive ductal carcinoma was the main type,which accounting for 82.22%（37/45）,Ⅱ stage of the main TNM clinical stage,accounting for about 53.33%（24/45）.42 patients were tested by Immunohistochemistry,The positive rate of estrogen receptor（ER）was 88.10%（37/42）,the positive rate of progesterone receptor（PR）was 80.95%（34/42）,the human epidermal growth factor was The positive rate of body 2（HER-2）was 19.05%（8/42）The DFS survival rate of 5-year was 55.56%（25/45）,The OS survival rate of 5-year was 73.33%（33/45）,3patients of 0Phase,accounting for100%（3/3）,8patients ofⅠ Phase,account

关 键 词：男性乳腺癌 手术 生存质量 影响因素 

分 类 号：R737.9[医药卫生—肿瘤]