原发性甲状腺癌对乳腺癌患者预后的影响  

Influence of primary thyroid cancer on prognosis of breast cancer

作　　者：陈新月 李娟娟[1] 吴奇[1] 孙圣荣[1] Chen Xinyue;Li Juanjuan;Wu Qi;Sun Shengrong(Department of Breast and Thyroid Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院乳腺甲状腺外科,430060

出　　处：《中华实验外科杂志》2022年第4期636-639,共4页Chinese Journal of Experimental Surgery

摘　　要：目的评估甲状腺癌(TC)和乳腺癌(BC)患者的临床特征,并确定这两种肿瘤的患病顺序对预后的影响。方法在监测、流行病学和结局数据库中选择2000年至2012年间来自美国18个地区的女性BC患者和TC患者,并诊断情况分为3组,第1组患者仅患有BC(BC组);第2组患者先诊断有TC后又被诊断出BC(TC2BC组);第3组患者先诊断有BC后又被诊断出TC(BC2TC组)。临床资料差异分析采用χ^(2)检验。应用倾向性评分匹配(PSM)平衡组间差异。生存分析采用Kaplan-Meier对数秩检验。采用单因素及多因素Cox回归分析检验BC预后危险因素。结果经PSM后,1260对伴或不伴有第二原发性TC的患者被纳入生存分析。BC2TC组的OS和DSS均优于BC组[OS:风险比率(HR):0.511(0.421~0.620),P<0.01;DSS:HR:0.458(0.346~0.606),P<0.01]。在Luminal A和Luminal B型乳腺癌的亚组分析中,BC2TC组的OS均优于BC组[Luminal A,HR:0.440(0.291~0.664),P<0.01;Luminal B,HR:0.365(0.140~0.950),P<0.05]。结论第二原发TC可以改善BC患者的预后,尤其是Luminal型的女性BC患者。Objective To evaluate the clinical characteristics of patients with breast cancer(BC)and thyroid cancer(TC),and investigate the effect of the sequence of two malignancies on survival.Methods Female patients with BC and TC from 18 regions of the United States(2000-2012)were selected from the Surveillance,Epidemiology and outcome Database,and were classified as three cohorts:the first cohort consisted of patients only having BC(BC cohort);the second cohort contained TC patients with a second primary BC(TC2BC cohort),and the third cohort was BC patients with a second primary TC(BC2TC cohort).Chi-square test was used for the differences of clinical data.The propensity score matching(PSM)was used to balance the baseline characteristics.Kaplan-Meier log-rank test was used for survival analysis.The univariate and multivariate Cox regression analyses were used to test the prognostic risk factors of BC.Results After PSM,1260 pairs of patients with or without second primary TC were included in the survival analysis.The patients in BC2TC cohort had better OS and DSS than those in BC cohort[for OS,Hazard Ratio(HR):0.511(0.421-0.620),P<0.01;for DSS,HR:0.458(0.346-0.606),P<0.01].In the subgroup analysis of luminal A and luminal B subtypes,the OS of BC2TC cohort was better than that of BC cohort[for luminal A:HR:0.440(0.291-0.664),P<0.01;for luminal B:HR:0.365(0.140-0.950),P<0.05].Conclusion The second primary TC may improve the prognosis of BC patients,especially in women with luminal BC.

关 键 词：乳腺癌 甲状腺癌 预后 甲状腺激素 

分 类 号：R736.1[医药卫生—肿瘤] R737.9[医药卫生—临床医学]