摘要
目的:分析乳腺癌不同组织学类型的发病率,并进行预后相关性研究。方法:应用2003年版世界卫生组织(WHO)乳腺癌分类,对1998～2001年经治疗并有完整随访资料的565例原发乳腺癌重新进行组织学分析,并利用NPI值进行预后相关因素分析。结果:565例乳腺癌患者平均年龄52.86岁,79.3%的患者年龄位于40～69岁,小于40岁占11.3%。临床分期0、Ⅰ、Ⅱ、Ⅲ、Ⅳ期分别占5.3%、27.1%、55.0%、11.3%、1.2%。导管原位癌30例(5.3%),浸润癌535例(94.7%)。其中浸润性导管癌(非特殊类型)432例,占76.5%,位居首位。混合型癌31例(5.5%),黏液癌23例(4.1%),浸润性小叶癌22例(3.9%),浸润性筛状癌13例(2.3%),其他14例(2.5%)。浸润性乳腺癌患者,淋巴结转移率为42.4%。10年总生存率及无瘤生存率分别为90.76%和84.10%。经单因素分析显示,肿瘤的大小及临床分期与10年总生存率及无瘤生存率呈负相关(P均<0.01)。经Cox多因素分析显示,NPI值与10年总生存率呈负相关(P<0.001),组织学分级(P=0.0271)和淋巴结分期(P<0.001)与无瘤生存率负相关。结论:该院经治乳腺癌年轻患者所占比例高于欧美,浸润性小叶癌的发生率低于欧美国家,与亚洲其他国家接近。肿瘤组织学分级、淋巴结分期、肿瘤大小、临床分期,尤其是NPI值可以作为判断预后的指标。严格鉴别特殊类型的乳腺癌对判断预后有一定的指导意义。
Objective： To analyze the incidence of breast cancer of different histological types and related prognosis. Methods： 565 cases with primary breast cancer who were treated from 1998 - 2001 and had complete follow - up data were re - evaluated histologically according to the World Health Organization classification of breast cancer （2003） , then related prognostic factors were analyzed with NPI value. Results： The average age was 52. 86 years old, 79. 3% of the cases were in the age range between 40 and 69 years old, the cases less than 40 years old accounted for 11.3%. The cases with clinical stage 0, Ⅰ、Ⅱ、Ⅲ、Ⅳ accounted lotS. 3% , 27. 1% , 55.0% , 11.3% and l. 2% , respectively. 30 cases （5.3%） were diagnosed as ductal carcinoma in situ, 535 cases （94. 7% ） were diagnosed as invasive carcinoma, 432 cases （76. 5% ） were diagnosed as invasive ductal carcinoma （not specific types） , ranking first. The proportions of mixed type carcinoma, mueinous carcinoma, invasive lobular carcinoma, invasive cribriform carcinoma and other types were 5.5% （31 cases） , 4. 1% （23 cases） , 3.9% （22 cases）, 2. 3% （13 cases）, and 2. 5% （14 cases）, respectively. In cases with invasive breast cancer, the incidence of lymphatic metastasis was 42. 4%. The ten years overall survival rate and disease - free survival rate were 90. 76% and 84. 10%. There was a negative correlation between tumor size and clinical stages, the ten years overall survival rate and disease - free survival rate （ P 〈 0. 01 ） ; there was a negative correlation between NPI value and the ten years overall survival rate （ P 〈 0. 001 ） , there was a negative correlation between histological grades （P = 0. 027 1 ）, lymph node staging （P 〈 0. 001 ） and disease- free survival rate. Conclusion： The proportion of young patients with breast cancer is higher than those in Europe and the United States, the incidence of infiltrating lobular carcinoma is lower than those in Europe and the United States, but is similar to other countries in Asia. Tumor histological grades, lymph node staging, tumor size and clinical stages, especially NPI value, maybe used as indexes of predicting prognosis, strict differentiation of specific types of breast cancer plays a certain directive role in predicting prognosis.
出处
《中国妇幼保健》
CAS
北大核心
2010年第13期1761-1766,共6页
Maternal and Child Health Care of China
