肿瘤中心晚期乳腺癌治疗10年回顾性分析

发布时间：2018-01-03 00:45

  本文关键词：肿瘤中心晚期乳腺癌治疗10年回顾性分析　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

  更多相关文章： 晚期乳腺癌 转移部位 综合治疗 生存率分析

【摘要】：目的:对777例吉林大学白求恩第一医院肿瘤中心晚期乳腺癌患者的临床病理特点、治疗方法、转移部位以及预后进行回顾性分析,总结我中心晚期乳腺癌的转移特点,治疗情况,探讨影响晚期乳腺癌预后的危险因素。方法:收集2007年1月至2016年12月于我院肿瘤中心进行治疗的晚期乳腺癌777例的基本资料,临床病理特点,各种治疗手段以及预后和随访情况,完善晚期乳腺癌数据库,并进行回顾性分析,应用数据软件进行分析,了解晚期乳腺癌的复发转移特点,临床治疗情况,以及影响预后的危险因素。结果:1.晚期乳腺癌一线化疗药物以紫杉醇为主,到2、3线治疗是以紫衫、铂类为主。2.晚期乳腺癌一线化疗方案以紫杉醇+蒽环类为主,2线、3线治疗是多种治疗方案并存。3.晚期乳腺癌第一次复发时与初治时Ki-67、ER/PR、HER-2以及分子分型均有差异。并且复发后转向更有浸润性以及较差预后的趋势大。4.晚期乳腺癌第一次复发部位与分子分型和疾病分期相关,Her-2过表达型易发生远处转移,疾病分期较高易发生远处转移。转移器官个数与疾病复发风险相关,复发风险越高,转移器官个数越多。5.影响晚期乳腺癌3年总生存期的单因素分析结果显示:病理类型、TNM分期、ER/PR、危险度分级、组织学分级、转移部位及转移部位个数是影响3年OS的显著因素(P0.05)。多因素分析显示:ER/PR、转移部位个数是影响乳腺癌患者预后的独立危险因素,ER/PR双阳性且转移部位个数≤3的患者预后较好。结论:1.我中心晚期乳腺癌1年、3年、5年的生存率分别为90%、69%和55%,中位生存时间为78个月,ER/PR、转移器官个数是影响晚期乳腺癌预后的独立危险因素。2.解剖学分期不能完全反映病人的预后,解剖学分期与肿瘤细胞生物性特性结合的功能分期是未来评估乳腺癌预后的指标。3.晚期乳腺癌复发后病理参数可能会发生变化,且向恶性程度更高,侵袭更强的方向发展,因此二次活检对于治疗和预后分析有指导性意义。
[Abstract]:Objective: to retrospectively analyze the clinicopathological features, treatment methods, metastatic sites and prognosis of 777 patients with advanced breast cancer in the tumor center of Bai Qiuen first Hospital of Jilin University. To summarize the characteristics of metastasis and treatment of advanced breast cancer in our center. To investigate the risk factors affecting the prognosis of advanced breast cancer. Methods: from January 2007 to December 2016, we collected the basic data of 777 patients with advanced breast cancer who were treated in our hospital from January 2007 to December 2016. Clinicopathological features, treatment methods, prognosis and follow-up, improve the database of advanced breast cancer, and carry out retrospective analysis, data software analysis, to understand the characteristics of recurrence and metastasis of advanced breast cancer. Results 1. Paclitaxel was the main chemotherapeutic drug in advanced breast cancer. The first line chemotherapy regimen of advanced breast cancer is paclitaxel anthracycline 2 line 3 line treatment. 3. Advanced breast cancer is the first recurrence and the first treatment of Ki-67. ER/PR. HER-2 and molecular typing were different, and the tendency of turning to more invasive and poor prognosis after recurrence was greater. 4. The first recurrence site of advanced breast cancer was related to molecular classification and disease stage. Overexpression of Her-2 is prone to distant metastasis and disease stage is higher. The number of metastatic organs is related to the risk of disease recurrence, the higher the risk of recurrence. The number of metastatic organs. 5. The results of univariate analysis on the total survival time of 3 years of advanced breast cancer showed that the pathological type was TNM stage and ERP, risk grade, histological grade. Multivariate analysis showed that the number of metastatic sites was an independent risk factor for the prognosis of breast cancer patients, and the number of metastatic sites was a significant factor affecting the prognosis of breast cancer patients for 3 years (P0.051.Multivariate analysis showed that the number of metastatic sites was an independent risk factor for the prognosis of breast cancer patients. The prognosis of patients with ER/PR double positive and the number of metastatic sites 鈮，

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