96例乳腺叶状肿瘤复发转移及预后相关因素分析  

Analysis of recurrence, metastasis, and prognostic factors in 96 patients with phyllodes tumor of breast

作　　者：刘姗灵 冉冉 涂刚[1] LIU Shanling;RAN Ran;TU Gang(Department of Endocrine and Breast Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,P.R.China)

机构地区：[1]重庆医科大学附属第一医院内分泌乳腺外科

出　　处：《中国普外基础与临床杂志》2020年第1期58-62,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的分析乳腺叶状肿瘤患者的临床病理因素与局部复发、远处转移及预后的关系。方法回顾性分析2011年3月至2018年12月期间重庆医科大学附属第一医院收治的96例乳腺叶状肿瘤患者的临床病理及随访资料,采用χ~2检验及logistic多因素回归分析患者临床病理因素与局部复发和远处转移的关系;运用Kaplan-Meier法计算无病生存率(DFS),采用log-rank检验及Cox比例风险模型分析患者各临床病理因素与预后的关系。结果 96例乳腺叶状肿瘤患者中94例为单侧发病,2例为双侧发病;良性36例,交界性34例,恶性26例。有27例患者术后出现局部复发,4例患者发生远处转移,4例患者死亡,1、3、5年累积DFS分别为81.2%、64.9%、64.9%,5年累积总生存率为92.3%。多因素分析显示,年龄、肿瘤类型和手术方式与局部复发有关(P<0.050),未发现各临床病理因素与远处转移有关(P>0.050),发现肿瘤类型是影响预后的独立影响因素(P<0.050)。结论乳腺叶状肿瘤复发率较高,年龄及肿瘤类型是影响术后局部复发的独立因素,外科手术为主要治疗方式,扩大切除术或乳房全切除术为可供选择的手术方式。Objective To study the relationship between clinical features of patients with phyllodes tumor of breast(PTB) and reccurence, distant metastasis, and prognosis. Methods The clinical data of 96 patients with PTB treated in this hospital from March 2011 to December 2018 were retrospectively analyzed. The correlation of clinical features with local recurrence and distant metastasis were analyzed by the Chi-square test and logistic regression. The Kaplan-Meier method was used to compute disease-free survival(DFS). The correlation of clinical features with prognosis was analyzed by the log-rank test and Cox regression. Results Ninety-four patients with PTB showed the unilateral single nodule, 2 patients showed the bilateral nodule. The benign tumor had 36 patients, borderline tumor had 34 patients,malignant tumor had 26 patients. A total of 27 patients had local recurrence, 4 patients had distant metastasis, 4 patients died during the follow-up period. The 1-, 3-, and 5-year accumulate DFS rate was 81.2%, 64.9%, and 64.9%, respectively.The accumulate 5-year overall survival rate was 92.3%. The multivariate analysis showed that the age, types of tumor, and surgical method were related to the local recurrence(P<0.050), and no clinicopathological factors were found to be related to the distant metastasis(P>0.050). It was found that type of tumor was the independent factor affecting prognosis(P<0.050). Conclusions For PTB, the recurrence rate is higher, the age and tumor types are the independent recurrent factors. Surgical treatment is the primary management, extend resection and mastectomy are alternative operation.

关 键 词：乳腺肿瘤 叶状肿瘤 复发 预后 

分 类 号：R737.9[医药卫生—肿瘤]