雌激素受体阳性初诊Ⅳ期乳腺癌患者预后影响因素分析  

Prognostic influencing factors analysis of patients with estrogen receptor-positive de novo stage Ⅳbreast cancer

作　　者：孙建娜[1] 任崇禧[1] 孔令军[1] 穆坤 姜秀贞 王晓蕊[2] Sun Jianna;Ren Chongxi;Kong Lingjun;Mu Kun;Jiang Xiuzhen;Wang Xiaorui(Department of Breast Cancer,Cangzhou Hospital of Integrated TCM-WM,Hebei Province,Cangzhou 061001,China;Department of Breast Medicine,Tianjin Medical University Cancer Hospital,Tianjin 300060,China)

机构地区：[1]河北省沧州中西医结合医院乳腺中心,沧州061001 [2]天津医科大学肿瘤医院乳腺内科,天津300060

出　　处：《肿瘤研究与临床》2023年第7期526-531,共6页Cancer Research and Clinic

摘　　要：目的探讨雌激素受体(ER)阳性初诊Ⅳ期乳腺癌患者预后影响因素。方法回顾性分析2010年2月至2017年12月天津医科大学肿瘤医院与河北省沧州中西医结合医院收治的339例ER阳性初诊Ⅳ期乳腺癌患者的临床资料。纳入年龄、主诉时间、临床T/N分期、转移部位、分子标志物表达及治疗模式等相关因素, 采用单因素log-rank检验和多因素Cox比例风险模型分析其对患者总生存(OS)的影响。结果单因素分析显示, ER阳性患者初诊临床N分期、初诊转移部位、ER表达水平、孕激素受体(PR)表达水平、Ki-67阳性指数、p53表达、内分泌治疗、初诊化疗情况、原发灶手术、原发灶放疗情况分层患者间OS比较, 差异均有统计学意义(均P<0.01)。多因素Cox回归分析结果显示, 初诊转移部位、Ki-67阳性指数、原发灶手术、原发灶放疗情况均是患者OS的独立影响因素(均P<0.01)。结论寡转移、Ki-67阳性指数≤20%、接受原发灶手术、原发灶放疗的ER阳性初诊Ⅳ期乳腺癌患者预后较好。Objective To investigate the factors influencing the prognosis of patients with estrogen receptor(ER)-positive de novo stageⅣbreast cancer.Methods The clinical data of 339 patients with ER-positive de novo stageⅣbreast cancer treated in Tianjin Medical University Cancer Hospital and Cangzhou Hospital of Integrated TCM-WM from February 2010 to December 2017 were retrospectively analyzed.Related factors such as age,time of chief complaint,the clinical T/N stage,site of metastasis,expressions of molecular markers and treatment mode were included.Univariate log-rank test and multivariate Cox regression model were used to analyze the effects of prognostic factors on patients'overall survival(OS).Results Univariate analysis showed that there were statistically significant differences in the OS of patients stratified by clinical N stage at first diagnosis,metastasis sites at first diagnosis,ER expression,progesterone receptor(PR)expression,Ki-67 positive index and p53 expression,endocrine therapy,chemotherapy at first diagnosis,surgery and radiotherapy of the primary lesions(all P<0.01).Multivariate Cox regression analysis results showed that metastasis sites at first diagnosis,Ki-67 positive index,surgery and radiotherapy of the primary lesions were all independent influencing factors of OS for breast cancer patients(all P<0.01).Conclusions Patients with ER-positive de novo stageⅣbreast cancer have a good prognosis when they have oligometastasis,Ki-67 positive index≤20%,and they receive surgery and radiotherapy of the primary lesions.

关 键 词：乳腺肿瘤 受体 雌激素 预后 

分 类 号：R737.9[医药卫生—肿瘤]