基于SEER数据库回顾性分析乳腺包裹性乳头状癌的临床特征及预后  

Retrospective analysis of clinical features and prognosis of breast encapsulated papillary carcinoma based on SEER database

作　　者：王文彦 张铁[1] 朱强[1] 王丕琳[1] Wang Wenyan;Zhang Tie;Zhu Qiang;Wang Pilin(Department of Breast,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院乳腺科,北京100070

出　　处：《国际外科学杂志》2022年第6期381-387,I0004,共8页International Journal of Surgery

摘　　要：目的分析乳腺包裹性乳头状癌的临床病理特征、生存情况及相关预后影响因素。方法利用美国国立癌症研究所监测、流行病学和结果(SEER)数据库搜索并筛选出2010年1月—2015年12月乳腺包裹性乳头状癌及浸润性导管癌的数据。通过倾向得分匹配调整两组之间的基线混杂因素。Kaplan-Meier法用于计算总生存期(OS)和乳腺癌特异性生存期(BCSS)的累积生存曲线。采用单因素Log-rank检验和多因素Cox回归分析评价这些因素的预后价值。结果本研究共纳入浸润性导管癌患者184524例和包裹性乳头状癌患者175例。与浸润性导管癌患者相比,60岁以上的包裹性乳头状癌患者比例较高,淋巴结转移率低,雌激素受体阳性、孕激素受体阳性和人表皮生长因子受体2阴性比例较高(P<0.05)。倾向得分匹配调整后,与浸润性导管癌患者相比,包裹性乳头状癌患者OS较差,而BCSS优于浸润性导管癌患者(P<0.05)。单因素和多因素Cox回归分析结果显示,年龄、手术方式和N分期与较差的OS相关,而手术方式、T分期、N分期和分子分型与较差的BCSS相关(P<0.05)。结论乳腺包裹性乳头状癌相比于浸润性导管癌的BCSS相对较好,淋巴结转移率低。肿瘤分期、分子分型与乳腺包裹性乳头状癌的预后存在一定的相关性。Objective To analyze the clinicopathological features,survival and related prognostic factors of encapsulated papillary carcinoma(EPC)of breast.Methods Data on EPC and invasive ductal carcinoma(IDC)of the breast from January 2010 to December 2015 were searched and screened using the National Cancer Institute Surveillance,Epidemiology,and End Results(SEER)database.Propensity score matching(PSM)was used to adjust for baseline confounding between the EPC and IDC groups.The Kaplan-Meier method was used to calculate cumulative survival curves for overall survival(OS)and breast cancer-specific survival(BCSS).Prognostic value of these factors were assessed by univariate Log-rank test and multivariate Cox regression analysis.Results In this study,184524 patients with IDC and 175 patients with EPC were included.Compared with patients with IDC,patients with EPC over 60 years old had a higher proportion,a lower rate of lymph node metastasis,and a higher proportion of estrogen receptor positive,progesterone receptor positive and human epidermal growth factor receptor 2 negative(P<0.05).After PSM adjustment,OS of patients with EPC was worse than that of IDC,and BCSS was better than that of IDC(P<0.05).Univariate and multivariate analysis showed that age,surgical approach and N stage were associated with poorer OS,while surgery approach,T stage,N stage and molecular typing were associated with worse BCSS(P<0.05).Conclusions Compared with IDC,EPC of breast has better BCSS and lower lymph node metastasis rate.There is a certain correlation between tumor stage and molecular type and prognosis of EPC.

关 键 词：乳腺肿瘤 包裹性乳头状癌 危险因素 预后 

分 类 号：R737.9[医药卫生—肿瘤]