早期三阴性乳腺癌术后辅助化疗疗效及预后分析  

作　　者：黄银 谢小红[2] 

机构地区：[1]浙江中医药大学第一临床医学院,310053 [2]浙江省中医院,310006

出　　处：《浙江临床医学》2025年第2期212-215,共4页Zhejiang Clinical Medical Journal

摘　　要：目的探究T1N0M0期三阴性乳腺癌患者接受术后辅助化疗的疗效。方法回顾性分析上海交通大学乳腺癌数据库2010~2020年的T1N0M0期三阴性女性乳腺癌患者数据。根据是否接受化疗,分为化疗组和未化疗组,对比两组的病理特征,采用Kaplan-Meier法进行生存预后分析。通过单因素及多因素Cox回归模型评估影响无病生存期(DFS)的预后因素。结果共纳入305例T1N0M0期三阴性乳腺癌患者,化疗组223例,未化疗组82例。两组在年龄、生育情况、月经情况、既往乳腺疾病史、手术方式、手术部位和术后放疗方面差异无统计学意义(P>0.05)。而在组织学分级、病理类型、Ki-67及肿块大小方面差异有统计学意义(P<0.05)。Kaplan-Meier生存曲线分析显示,化疗组与未化疗组在无病生存期(P=0.180)和总生存期(P=0.084)方面差异无统计学意义。多因素Cox回归分析表明,乳房全切术及组织学分级三级是影响T1N0M0期三阴性乳腺癌DFS的独立危险因素(HR>1,P<0.05)。结论T1N0M0期三阴性乳腺癌患者接受辅助化疗与否的疗效差异不明显,提示该类患者的化疗应个体化。乳房全切术和组织学分级三级的患者更易复发和转移。Objective To investigate the efficacy of adjuvant chemotherapy in patients with stage T1N0M0 triple-negative breast cancer(TNBC)after surgery.Methods A retrospective analysis was conducted on data from female patients with T1N0M0 stage TNBC in the Shanghai Jiao Tong University Breast Cancer Database from 2010 to 2020.Patients were divided into chemotherapy and non-chemotherapy groups based on whether they received chemotherapy post-surgery,and the pathological characteristics of the two groups were compared.Kaplan-Meier method was used for survival prognosis analysis.Univariate and multivariate Cox regression models were applied to evaluate prognostic factors affecting disease-free survival(DFS).Results A total of 305 patients with T1N0M0 stage TNBC were included,with 223 in the chemotherapy group and 82 in the non-chemotherapy group.There were no statistically significant differences between the two groups in terms of age,reproductive history,menstrual history,history of breast disease,surgical methods,surgical sites,and postoperative radiotherapy(P>0.05).However,there were statistically significant differences in histological grade,pathological type,Ki-67,and tumor size(P<0.05).Kaplan-Meier survival curve analysis showed no statistically significant differences in DFS(P=0.180)and overall survival(OS)(P=0.084)between the chemotherapy and non-chemotherapy groups.Multivariate Cox regression analysis indicated that mastectomy and grade III histology were independent risk factors affecting DFS in T1N0M0 stage TNBC(HR>1,P<0.05).Conclusion There was no significant difference in efficacy between T1N0M0 stage TNBC patients who received adjuvant chemotherapy and those who did not,suggesting that chemotherapy for this group of patients should be individualized.Patients with whole mastectomy and grade III histology are more likely to experience recurrence and metastasis.

关 键 词：三阴性乳腺癌 化疗 生存预后 危险因素 

分 类 号：R73[医药卫生—肿瘤]