齐齐哈尔地区三阴性乳腺癌的临床病理特征及预后分析
发布时间：2018-03-28 17:42
本文选题：三阴性乳腺癌 切入点：临床病理特征 出处：《青海大学》2015年硕士论文
【摘要】：目的:探讨三阴性乳腺癌在齐齐哈尔地区的临床特点、病理特征、复发转移率及生存情况,以便更深入地了解三阴性乳腺癌在齐齐哈尔地区的发生及发展规律,进而为指导齐齐哈尔地区临床医师制定更为科学的、个体化的治疗方案提供一定的帮助。方法:收集齐齐哈尔医学院附属第三医院2008年1月1日-2009年12月31日经手术治疗的156例乳腺癌女性患者的临床资料,其中经病理学证实雌激素受体、孕激素受体和人类表皮生长因子受体2为阴性的三阴性乳腺癌42例。临床资料包括年龄、绝经状态、家族史、肿瘤大小、临床分期、术前淋巴结情况、组织学分级、病理类型、化疗方案、手术方式等;对其患者进行必要的随访(电话随访、微信随访、医生APP及信访),以患者手术第一天为起点,研究结局定为因肿瘤死亡,随访终点为患者死亡、失访。到随访的截止时间其为止,死于其他的原因、跟踪截止或者失访仍生存者计为截尾值。回顾性分析TNBC的临床特点、病理特征、复发转移以及生存情况,所有数据采用SPSS21.0统计软件处理,临床病理特征比较分析采用x2检验;患者生存情况用Kaplan-Meier方法进行分析;两组5年生存率比较用log-rank检验。多因素分析采用Cox回归分析,双侧检验,检验水准α㩳0.05。结果： 1.156例乳腺癌的患者中,42例的三阴性乳腺癌,占26.92%;2.三阴性乳腺癌及非三阴性乳腺癌都以年龄≥45岁、已绝经无家族史、肿块大小以≤5cm居多,但三阴性乳腺癌淋巴结状态阳性居多(64.29%),较非三阴性乳腺癌有显著差异;三阴性乳腺癌浸润性导管癌占64.29%,与非三阴性乳腺癌相比较无统计学差异;3.三阴性乳腺癌与非三阴乳腺癌相比有较高复发转移率(x2=5.095,P㩳0.05),其中以肺转移多见(x2=5.200,P㩳0.05);4.生存情况:三阴性乳腺癌5年DFS、5年OS明显低于非三阴性乳腺癌,预后不好;5.TNBC预后的单因素分析:年龄、术前淋巴结状态、肿瘤大小、临床分期和手术方式是影响DFS的单因素,肿瘤大小、临床分期、淋巴结状态和手术方式是影响5年OS的单因素;6.多因素分析:发现仅有年龄和淋巴结状态才是影响5年DFS的独立因素,而仅有肿瘤大小才是影响5年OS的独立因素。结论： 1.三阴性乳腺癌占同期乳腺癌类型的26.92%;2.三阴性乳腺癌具有临床分期晚、术前淋巴结阳性多、组织学分级差的特点;3.三阴性乳腺癌复发转移率高,明显肺转移的特点;4.三阴性乳腺癌比非三阴性乳腺癌生存时间短;5.年龄和淋巴结状态是影响5年DFS的多因素,而肿瘤大小是影响5年OS的多因素。
[Abstract]:Objective: to investigate the clinical features, pathological features, recurrence and metastasis rate and survival status of triple negative breast cancer in Qiqihar, so as to understand the occurrence and development of triple-negative breast cancer in Qiqihar. In order to guide clinicians in Qiqihar region to formulate more scientific, Methods: the clinical data of 156 female breast cancer patients treated surgically from January 1, 2008 to December 31, 2009 in the third affiliated Hospital of Qiqihar Medical College were collected. Among them, 42 cases of breast cancer with negative estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 were confirmed by pathology. Clinical data included age, menopausal status, family history, tumor size, clinical stage. Preoperative lymph node status, histological grade, pathological type, chemotherapy regimen, operation method, etc., necessary follow-up (telephone follow-up, WeChat follow-up, doctor APP and letter visit), starting from the first day of operation. The outcome of the study was determined to be due to tumor death, and the end point of follow-up was death and loss of visit. To the deadline of follow-up, to die from other causes, follow-up cutoff or missing survivors were counted as amputation. The clinical features of TNBC were analyzed retrospectively. The pathological features, recurrence, metastasis and survival were analyzed by SPSS21.0 software, and the clinicopathological features were analyzed by x2 test, and the survival of the patients was analyzed by Kaplan-Meier method. The 5-year survival rate of the two groups was compared by log-rank test. Multivariate analysis was performed with Cox regression analysis, bilateral test, and test level 伪? Results: among the 1.156 patients with breast cancer, 42 cases (26.92%) had tri-negative breast cancer (26.92%) and non-triple-negative breast cancer (non-triple-negative breast cancer) were aged more than 45 years, had no family history after menopause, and the size of tumor was 鈮，
本文编号：1677364
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/1677364.html
最近更新
教材专著
