基于SEER数据库分析乳腺分泌性癌与浸润性导管癌的临床病理特征和生存结果  

Analysis of clinicopathological features and survival results in secretory breast carcinoma and invasive ductal carcinoma of breast based on SEER database

作　　者：王虎霞 赵静 刘奋德 王美霞 Wang Huxia;Zhao Jing;Liu Fende;Wang Meixia(Mammary Department,Shaanxi Provincial Cancer Hospital,Xi′an 710061,China;Health Examination Center,Shenmu Hospital,Shenmu 719300,China)

机构地区：[1]陕西省肿瘤医院乳腺中心,西安710061 [2]神木市医院体检中心,神木719300

出　　处：《中国医师杂志》2022年第12期1816-1822,共7页Journal of Chinese Physician

基　　金：陕西省重点研发计划项目(2022SF-010)。

摘　　要：目的分析乳腺分泌性癌(SBC)与浸润性导管癌(IDC)之间临床病理特征和预后的差异,并探讨SBC对乳腺癌预后的影响。方法在监测、流行病学和最终结果(SEER)数据库检索1990年—2016年的SBC和IDC患者,经筛选后确定109例SBC(SBC组)和558814例IDC(IDC组)入组研究,比较两组临床病理特征差异,采用倾向性得分匹配方法按1∶4比例匹配平衡混杂因素,分析匹配前后两种组织学类型乳腺癌特异性生存期(BCSS)和总生存期(OS),绘制Kaplan-Meier生存曲线,采用log-rank检验比较组间生存差异。Cox比例风险回归模型进行单因素及多因素分析确定乳腺癌预后的影响因素。结果SBC组与IDC组在诊断年龄、婚姻状态、性别、组织学分级、AJCC N分期、雌激素受体(ER)、孕激素受体(PR)表达方面差异有统计学意义(均P<0.05)。SBC组BCSS与IDC组差异无统计学意义(P=0.541),OS优于IDC组(P<0.05)。Cox单因素及多因素回归分析显示诊断年龄、种族、婚姻、性别、病变部位、组织学分级、AJCC分期、手术方式和ER、PR表达均是影响BCSS和OS的相关因素(均P<0.05)。SBC是影响乳腺癌OS的独立影响因素(P<0.05)。按照1∶4的比例进行倾向性得分匹配后两组BCSS与OS差异均无统计学意义(均P<0.05)。Cox回归分析显示AJCC T分期、PR阴性表达是BCSS的影响因素(均P<0.05),诊断年龄、AJCC T分期是OS的影响因素(均P<0.05)。SBC不再是乳腺癌OS的影响因素。结论SBC与IDC预后无显著性差异,SBC不是乳腺癌预后的影响因素。Objective To analyze the differences of clinicopathological features and prognosis between secretory breast carcinoma(SBC)and invasive ductal carcinoma(IDC),and to explore the influence of SBC on the prognosis of breast cancer.Methods We retrieved data of patients diagnosed with SBC and IDC from The National Cancer Institute′s Surveillance,Epidemiology,and End Results(SEER)database between 1990 and 2016.109 cases of SBC(SBC group)and 558814 cases of IDC(IDC group)were collected.The clinicopathological features were compared between SBC and IDC groups.The tendency score matching method was used to match the balance confounding factors according to 1∶4 proportion.The breast cancer-specific survival time(BCSS)and overall survival time(OS)of the two histological types of breast cancer before and after matching were analyzed.The survival curve was drawn using the Kaplan-Meier method and compared with the log-rank test.Univariate and multivariate Cox regression analysis was used to determine the independent prognostic factors of breast cancer.Results There were significant difference in diagnostic age,marital status,sex,histological grade,American Joint Committee on Cancer(AJCC)N stage,estrogen receptor(ER)and progesterone receptor(PR)expression between SBC and IDC group(all P<0.05).The BCSS of SBC group was similar to IDC group,and OS was better than IDC(P<0.05).Univariate and multivariate regression analysis showed that diagnostic age,race,marriage,sex,location,histological grade,AJCC stage,treatment mode and ER,PR expression were all related factors affecting BCSS and OS(all P<0.05).SBC was an independent prognostic factor for OS(P<0.05).After propensity score matching according to 1∶4,there was no significant difference in BCSS and OS between the two groups(P<0.05).Cox regression analysis showed that AJCC T stage and PR negative expression were the influencing factors of BCSS(all P<0.05),and diagnostic age and AJCC T stage were the influencing factors of OS(all P<0.05).SBC was no longer an influencing factor

关 键 词：癌 导管 乳腺 乳腺分泌性癌 存活率分析 SEER数据库 

分 类 号：R737.9[医药卫生—肿瘤]