266例首诊Ⅳ期乳腺癌手术患者预后分析  

Prognostic analysis of 266 patients with stage IV breast cancer undergoing surgery for the first time

作　　者：孙建娜[1] 孔令军[1] 任崇禧[1] 穆坤 王晓蕊[2] Sun Jianna;Kong Lingjun;Ren Chongxi;Mu Kun;Wang Xiaorui(Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Cangzhou Hebei Province 061001,China;Tumor Hospital of Tianjin Medical University,Tianjin 300060,China)

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

出　　处：《中华普外科手术学杂志（电子版）》2024年第5期502-505,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：河北省2020年度医学医学科学研究课题计划(20200212)。

摘　　要：目的:探究首诊Ⅳ期乳腺癌手术患者首诊及术后临床病理特征,转移和治疗情况,旨在探讨其对预后的影响。方法:回顾性分析2007年2月至2017年12月两家医院收治的266例首诊Ⅳ期乳腺癌原发灶手术患者的临床病例资料。随访起始时间为患者确诊时间,随访截止时间为患者死亡时间或2020年12月31日。纳入年龄、主诉时间、首诊临床T/N分期、转移情况、术后分子标志物表达、手术时机、术后切缘、脉管癌栓情况、术后病理T/N分期及治疗情况,研究手术患者的预后相关因素。应用Stata 15.0软件进行统计学分析,预后的单变量分析采用Log-Rank检验,预后的多变量分析采用Cox回归模型分析。P<0.05为差异有统计学意义。结果:预后单因素分析:临床N分期,首诊转移情况,术后ER、PR表达情况,术后Ki-67表达水平,术后切缘情况,术后病理T、N分期和术后原发灶区域放疗与患者的OS相关(P值均<0.05)。预后多因素分析:首诊转移情况,术后Ki-67表达水平,术后病理T、N分期和术后原发灶区域放疗均是影响患者OS的独立预后因素(P值均<0.05)。结论:患者术后病理T、N分期低,首诊寡转移状态稳定,术后Ki-67≤20%,术后原发灶区域放疗生存更能获益。Objective:To investigate the clinicopathological features,metastasis and treatment of patients undergoing first diagnosis and postoperative surgery for stageⅣbreast cancer,and to explore the influence on prognosis.Methods:The clinical data of 266 patients with stageⅣprimary breast cancer undergoing surgery for the first time admitted to two hospitals from February 2007 to December 2017 were retrospectively analyzed.Follow-up started at the time of diagnosis and ended at the time of death or December 31,2020.Age,chief complaint time,first clinical T/N stage,metastasis,postoperative molecular marker expression,operation time,postoperative resection margin,vascular cancer embolus,postoperative pathological T/N stage and treatment were included to study the prognostic factors of patients undergoing surgery.Stata 15.0 software was used for statistical analysis.Log-Rank test was used for univariate analysis of prognosis,and Cox regression model was used for multivariate analysis of prognosis.P<0.05 was considered statistically significant.Results:Univariate analysis of prognosis:clinical N stage,first diagnosis metastasis,postoperative ER and PR expression,postoperative Ki-67 expression level,postoperative resection margin,postoperative pathological T and N stage and postoperative primary site radiotherapy were correlated with patients'OS(P<0.05).Multivariate analysis of prognosis:The first diagnosis of metastasis,the expression level of Ki-67 after surgery,the T and N stages of postoperative pathology,and the radiotherapy of the primary site were all independent prognostic factors affecting the patients'OS(P<0.05).Conclusion:The postoperative pathological T and N stages of the patient were low,the oligometastases were stable at the first diagnosis,and the postoperative Ki-67 was less than 20%.The survival of the patient with radiotherapy in the primary site was more beneficial.

关 键 词：首诊Ⅳ期乳腺癌 临床病理特征 预后 

分 类 号：R737.9[医药卫生—肿瘤]