T_(1-2)N_(0)M_(0)期乳腺癌患者术后复发转移及预后影响因素分析  

Analysis of factors influencing postoperative recurrence and metastasis and prognosis of stage T_(1-2)N_(0)M_(0) breast cancer patients

作　　者：王淑伟 邵姜超 林亚南 殷进军[1] Wang Shuwei;Shao Jiangchao;Lin Yanan;Yin Jinjun(Tumor Medical Center,Weihai Municipal Hospital,Cheeloo College of Medicine,Shandong University,Weihai 264200,China;Department of Science and Education,Weihai Municipal Hospital,Cheeloo College of Medicine,Shandong University,Weihai 264200,China)

机构地区：[1]山东大学附属威海市立医院肿瘤医学中心,威海264200 [2]山东大学附属威海市立医院科教科,威海264200

出　　处：《肿瘤研究与临床》2025年第2期101-106,共6页Cancer Research and Clinic

摘　　要：目的探讨早期乳腺癌患者术后复发转移及预后的主要影响因素及复发转移后全病变放疗的意义。方法回顾性队列研究。收集2006年1月至2019年1月山东大学附属威海市立医院收治的554例T_(1-2)N_(0)M_(0)期乳腺癌术后患者,对术后未发生复发转移和发生复发转移患者的临床病理特征进行比较。采用Kaplan-Meier法分析患者的总生存(OS)和无病生存(DFS)。预后影响因素的单因素分析采用log-rank检验,多因素分析采用Cox比例风险模型。复发转移患者按复发转移病灶是否进行放疗进行分组,所有复发转移病灶均行放疗为全病变放疗组,部分复发转移病灶行放疗为非全病变放疗组,所有复发转移病灶均未行放疗为未放疗组,比较各组间OS和无进展生存(PFS)。结果554例患者年龄(49±10)岁,其中术后复发转移患者56例(10.1%)。未发生复发转移和发生复发转移两组间绝经状态、病理分型、分化程度、雌激素受体或孕激素受体表达、病理分期、术后辅助化疗、术后辅助放疗、术后辅助内分泌治疗情况比较,差异均有统计学意义(均P<0.05)。5年OS率为96.9%,5年DFS率为95.9%。多因素Cox回归分析结果示,分化程度高(HR=0.300,P=0.011)、未术后辅助放疗(HR=0.097,P<0.001)、未术后内分泌治疗(HR=0.421,P=0.040)是DFS独立危险因素。分化程度高(HR=0.266,P=0.003)、未术后辅助放疗(HR=0.225,P=0.003)是OS独立危险因素。全病变放疗组的OS优于非全病变放疗组,差异有统计学意义(χ^(2)=6.73,P=0.010);两组PFS比较,差异无统计学意义(χ^(2)=3.51,P=0.061)。全病变放疗组与未放疗组的OS和PFS差异均无统计学意义(均P>0.05)。结论绝经状态、病理分型、分化程度、雌激素受体或孕激素受体表达、病理分期、术后辅助化疗、术后辅助放疗、术后辅助内分泌治疗可能影响T 1~2N 0M 0期乳腺癌患者术后发生复发转移。分化程度高、未术后辅助放疗及未术Objective To investigate the factors influencing recurrence and metastasis and prognosis of early breast cancer patients after surgery and the significance of all-foci radiotherapy after recurrence and metastasis.MethodsA retrospective cohort study was conducted.A total of 554 patients with stage T 1-2N 0M 0 breast cancer after surgery who were admitted to Weihai Municipal Hospital,Cheeloo College of Medicine,Shandong University from January 2006 to January 2019 were collected.The clinicopathological features were compared between patients with and without recurrence and metastasis after surgery.Kaplan-Meier method was used to analyze the overall survival(OS)and disease-free survival(DFS)of patients.The univariate analysis of prognostic factors was conducted using log rank test,while the multivariate analysis was conducted using Cox proportional hazards model.Patients with recurrence and metastasis are grouped according to whether the recurrence and metastasis lesions had received radiotherapy,patients with radiotherapy for all recurrence and metastasis lesions were classified as the all-foci radiotherapy group,patients with radiotherapy for partial recurrence and metastasis lesions were classified as non-all-foci radiotherapy group,and patients without radiotherapy for all recurrence and metastasis lesions were classified as non-radiotherapy group.The OS and progression free survival(PFS)were compared between groups.ResultsThe 554 patients were(49±10)years old,including 56 patients(10.1%)with recurrence and metastasis after surgery.There were statistically significant differences in menopausal status,pathological type,differentiation degree,estrogen receptor or progesterone receptor expression,pathological stage,postoperative adjuvant chemotherapy,postoperative adjuvant radiotherapy,and postoperative adjuvant endocrine therapy(all P<0.05).The 5-year OS and DFS were 96.9%and 95.9%,respectively.The multivariate Cox regression analysis showed that the high differentiation(HR=0.300,P=0.011),no postoperative adjuvan

关 键 词：乳腺肿瘤 放射治疗 全病变放射治疗 复发 转移 预后 

分 类 号：R73[医药卫生—肿瘤]