乳腺癌临床特征与预后分析

目的：总结经综合治疗的233例乳腺癌患者的临床病理特征及生存情况,探讨影响乳腺癌预后的因素。方法：建立乳腺癌患者的临床资料库,采用SPSS8.0统计软件对临床数据进行单因素及多因素生存分析,以发现影响乳腺癌长期生存的因素。结果：所有患者1、2、3、5和8年生存率分别为95.71%（223/233）、82.83%（193/233）、61.37%（143/233）、37.34%（87/233）和6.87%（16/233）。单因素分析显示腋淋巴结转移数目;原发肿瘤大小与生存呈负相关（P均〈0.001）;TNM晚期患者复发转移的患者中位生存明显缩短（P均〈0.0001）;术后辅助化疗方案选择含有蒽环类的方案组生存期优于不含有蒽环类的方案组（P〈0.05,X^2=9.99）;病理类型治疗方式与生存时间相关（P均〈0.01）。COX比例风险模型分析显示治疗方式、术后辅助性化疗方案和复发转移具有独立预后意义（P〈0.05）。Logistic分析结果显示,原发肿瘤大小、腋窝淋巴结转移状态、病理类型、综合治疗方式是影响乳腺癌复发转移的主要因素,其影响程度的排序依次是腋窝淋巴结转移、原发肿瘤大小、病理类型、综合治疗方式（P〈0.0001）。结论：乳腺癌患者的远期生存及复发转移与原发肿瘤大小、腋窝淋巴结转移状态、病理类型、术后化疗方案的选择及个体化综合治疗方式密切相关。

Clinical features and prognosis analysis of breast cancer

OBJECTIVE:To explore the prognostic factors through studying clinical-pathological features and survival status in 233 patients with breast cancer.METHODS:Database of the patients with breast cancer was established.The SPSS 8.0 software was used to analyze the prognostic factors through univariate and multivatiate method.RESULTS:The 1,2,3,5 and 8 years survival rates of the 233 cases were 95.71%(223/233),82.83%(193/233),61.37%(143/233),37.34%(87/233),6.87%(16/233),respectively.Based on univariate log-rank analysis,six variables were found to be of independent prognostic significance of survival:number of positive axillary lymph nodes(P<0.000 0),tumor size(P<0.001),histological type(P<0.01),treatment strategy(P<0.01),adjuvant chemotherapy regimen(P<0.05),TNM staging(P<0.000 1).Cox multivatiate analysis identified three poor prognostic factors:recurrence,the first line adjuvant chemotherapy regimen and multidisciplinary synthetic therapy(P<0.05).The logistic analysis showed that the major causes correlated with recurrence was the status of positive axillary lymph nodes,followed by tumor size,histological type and multidisciplinary synthetic therapy module(P<0.000 1).CONCLUSION:Longtime survival and the recurrence of breast cancer patients are correlated with the status of positive axillary lymph nodes,tumor size,pathological type,adjuvant chemotherapy regimen selection and individual multidisciplinary synthetic therapy.