基于SEER数据库乳腺肉瘤的临床病理特征、治疗及预后因素分析  

Analysis of clinicopathological features,treatment and prognostic factors of breast sarcoma based on SEER database

作　　者：侯令密[1,2] 谢少利 邓世山 苏小涵[1] 向乐朗 杨雅涵 杨宏伟 陈茂山[4] HOU Ling-mi;XIE Shao-li;DENG Shi-shan;SU Xiao-han;XIANG Le-lang;YANG Ya-han;YANG Hong-wei;CHEN Mao-shan(Department of Breast and Thyroid Surgery,Biological Targeting Laboratory of Breast Cancer,Academician(Expert)Workstation,Affiliated Hospital of North Sichuan Medical College;Department of Breast and Thyroid Surgery,Yingshan Hospital of West China Hospital.Sichuan University,Nanchong 637000,Sichuan;Clinical Medicine,Queen Mary College of Nanchang University,Nanchang 330000,Jiangxi;Department of Breast and Thyroid Surgery,Suining Central Hospital,Suining 629000,Sichuan,China)

机构地区：[1]川北医学院附属医院甲状腺乳腺外科,乳腺癌生物靶向研究室,院士专家工作站,四川南充637000 [2]四川大学华西医院营山医院甲状腺乳腺外科,四川南充637000 [3]南昌大学·玛丽女王学院临床医学,江西南昌330000 [4]遂宁市中心医院乳腺甲状腺外科,四川遂宁629000

出　　处：《川北医学院学报》2022年第1期16-21,共6页Journal of North Sichuan Medical College

基　　金：四川省卫生和计划委员基金会资助项目(17PJ599,18PJ005);四川省科学技术厅资助项目(19YYJC0384);川北医学院国家自然(社会)科学基金预研项目资助项目(CBY19-YZ13);川北医学院附属医院重点项目资助项目(2019ZD006)。

摘　　要：目的:探讨基于SEER数据库的乳腺肉瘤临床病理特征、治疗及预后因素。方法:提取SEER数据库1 061例诊断为乳腺肉瘤患者的数据,分析人群的临床病理特征及治疗方法的差异,通过Kaplan-Meier法分析生存预后,采用单因素和多因素Cox回归模型分析相关预后因素。结果:1 061例患者中,中位随访66个月(IQR:31~108个月),死亡118例(11.12%),其中乳腺肉瘤相关死亡73例(6.88%)。多因素校正Cox回归分析结果显示,年龄>55岁患者较≤55岁患者的肿瘤特异生存(TSS)(HR=1.65,95%CI:1.03~2.64,P=0.036)和总生存(OS)(HR=2.43,95%CI:1.68~3.53,P<0.001)差;黑种人较白种人的TSS(HR=2.49,95%CI:1.36~4.59,P=0.003)和OS(HR=2.04,95%CI:1.24~3.37,P=0.005)差;肿瘤>5 cm的较≤2 cm患者OS(HR=1.64,95%CI:1.08~248,P=0.020)差;乳房全切较保乳可以提高TSS(HR=0.40,95%CI:0.23~0.71)和OS(HR=0.43,95%CI:0.28~0.67,P<0.001);化疗可降低TSS(HR=2.40,95%CI:1.06~5.44,P=0.036)。结论:乳腺肉瘤患者年龄、种族、肿瘤大小、手术方式、化疗与预后相关,乳腺全切优于保乳,化疗及积极的腋窝淋巴结清扫不能为患者带来明确获益。Objective:To investigate the clinicopathological features,treatment and prognostic factors of breast sarcoma based on SEER database.Methods:The data of 1,061 patients diagnosed with breast sarcoma with complete follow-up data were extracted from the SEER database.The clinicopathological characteristics and differences in treatment were analyzed.The survival prognosis of the two groups was analyzed by Kaplan-Meier method,and the related prognostic factors were analyzed by univariate and multivariate Cox regression models.Results:Among the 1,061 patients,the median follow-up was 66 months(IQR:31-108 months),occurred 73(6.88%) breast sarcoma related death and 118(11.12%) overall death.Multivariate corrected Cox regression analysis showed that TSS(HR=1.65,95%CI 1.03-2.64,P=0.036) and OS(HR= 2.43,95%CI 1.68-3.53,P<0.001) were worse in patients with > aged 55 years than those with ≤55 years.The TSS(HR= 2.49,95%CI 1.36-4.59,P=0.003) and OS(HR=2.04,95%CI 1.24-3.37,P=0.005) were worse in black than in white.The OS of patients with tumor > 5 cm was worse than those with tumor ≤2 cm(HR=1.64,95%CI 1.08-248,P=0.020).Total mastectomy increased TSS(HR=0.40,95%CI 0.23-0.71) and OS(HR=0.43,95%CI 0.28-0.67,P<0.001) compared with breast conserving,and chemotherapy decreased TSS(HR=2.40,95%CI 1.06 to 5.44,P=0.036).Conclusion:Age,race,tumor size,surgical method and chemotherapy are related to prognosis of patients with breast sarcoma,and total mastectomy is better than breast conserving.Chemotherapy and aggressive axillary lymph node dissection could not provide a clear benefit.

关 键 词：乳腺肉瘤 SEER数据库 病理特征 预后分析 

分 类 号：R737.9[医药卫生—肿瘤]