乳腺非典型增生与乳腺癌患者危险因素分析

发布时间：2018-01-10 20:25

本文关键词：乳腺非典型增生与乳腺癌患者危险因素分析　出处：《昆明医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：乳腺癌目前已成为威胁女性健康与生命的最常见恶性肿瘤之一,但病因至今仍不明确,目前公认的乳腺癌发病机制为“多阶段发展模式学说”,即乳腺组织从正常→-般增生→非典型增生→原位癌→浸润癌,在某些因素作用下,可由量变至质变,转化为恶性肿瘤。非典型增生作为癌前病变是演变成为浸润癌的必经阶段,在某些致病因素的持续作用下,可以从量变发生质变,进而转化为恶性肿瘤,而在相反情况下,则能够长期稳定甚至发生可逆性变化,恢复至正常状态。可见,癌前病变绝非全部必然转化为癌,而只是较多可能性发展成为癌,是有条件的,因此对癌前病变即乳腺非典型增生阶段采取干预治疗手段,可以有效减少乳腺癌的发生率。深入开展乳腺非典型增生至乳腺癌的致病危险因素的研究,是降低疾病发病率的有效途径。国内外大量的研究结果显示乳腺癌死亡率的降低与普查发现大批早期癌显著相关,只要能早期诊断,得到及时正确的综合治疗,绝大多数患者能长期生存,甚至获得治愈。因此能有效提高乳腺癌生存率和降低绝对死亡率的决定因素不完全在于治疗手段,还应包括早期发现。由此可见,如何提高乳腺癌危险预测水平及更早的发现早期癌,是乳腺癌防治的关键。目前国内外多数大样本的研究都旨在探讨乳腺癌致病相关的风险因素,尤其是在风险因素的暴露强度和与刺激作用相关方面的研究较多,然而针对乳腺非典型增生与乳腺癌的风险因素的相关性研究却甚少。因此,有必要对该问题进行分析。目的：针对特定人群的一般情况,如：年龄,月经相关因素,流产频次,活产次数,烟酒史,高体重指数,恶性肿瘤家族史等因素进行深入研究,探讨乳腺非典型增生与乳腺癌相关危险因素,进一步查找乳腺非典型增生进展到乳腺癌过程中起关键作用的因素,并为乳腺癌的早期诊断和防御提供依据。方法：选取2013年1月-2014年10月期间收治在昆明医科大学附属甘美医院乳腺科组织病理学诊断为乳腺非典型增生患者111例作为病例组,同期诊断为原发乳腺癌患者156例作为对照组,于病案室调取原始病历资料,通过大量的参考文献,充分考虑可行性的指标,统一进行数据收集。采用SPSS19.0统计软件进行统计,采用logistic回归分析对乳腺非典型增生及乳腺癌相关高危因素进行探讨。从而得出乳腺非典型增生至乳腺癌的发病相关的危险因素。为预防乳腺癌的发生提供科学依据。结果：年龄、初潮年龄、是否绝经及流产均为乳腺非典型增生及乳腺癌的高危因素,特别是年龄、绝经与否及流产次数这三个方面关系更为密切。结论：乳腺非典型增生至乳腺癌的发展与患者年龄、初潮年龄、是否绝经及流产次数相关,因此对其的预防应在这些方面采取措施。
[Abstract]:At present, breast cancer has become one of the most common malignant tumors threatening women's health and life, but the etiology is still unclear. That is, mammary tissue from normal. 鈫扜eneral hyperplasia. 鈫扐typical hyperplasia. 鈫扖arcinoma in situ. 鈫扞nvasive carcinoma can be transformed from quantitative to qualitative to malignant tumor under the action of some factors. Atypical hyperplasia as a precancerous lesion is the necessary stage to develop into invasive carcinoma, and under the continuous action of some pathogenic factors. It can be changed from quantitative change to malignant tumor, and on the contrary, it can be changed steadily and even reversely for a long time, then it can return to normal state. Precancerous lesion is not necessarily transformed into cancer, but it is only possible to develop into cancer, which is conditional. Therefore, intervention therapy is adopted to precancerous lesion, i.e. atypical hyperplasia of mammary gland. Can effectively reduce the incidence of breast cancer. In-depth study of breast atypical hyperplasia to breast cancer risk factors. It is an effective way to reduce the incidence of disease. A large number of domestic and foreign studies show that the reduction of breast cancer mortality is significantly related to a large number of early cancer, as long as early diagnosis, get timely and correct comprehensive treatment. The majority of patients can survive for a long time, or even be cured. Therefore, the determinants that can effectively increase survival rate and reduce absolute mortality of breast cancer are not only in treatment, but also in early detection. How to improve the level of breast cancer risk prediction and early detection of early cancer is the key to the prevention and treatment of breast cancer. At present, most of the domestic and foreign large samples of research aimed to explore the risk factors associated with breast cancer. Especially in the risk factors of exposure intensity and stimulation-related research, however, there are few studies on the relationship between breast atypical hyperplasia and risk factors of breast cancer. Objective: to analyze the general situation of a specific population, such as age, menstrual factors, abortion frequency, number of live births, alcohol and tobacco history, high body mass index. The family history of malignant tumor and other factors were studied to explore the risk factors of atypical hyperplasia and breast cancer, and to find out the factors that play a key role in the progression of atypical hyperplasia of breast to the process of breast cancer. Methods: to provide evidence for early diagnosis and prevention of breast cancer. From January 2013 to October 2014, 111 patients with atypical hyperplasia of mammary gland were selected as the case group, who were diagnosed as atypical hyperplasia of mammary gland in Department of mammary gland of Ganmei Hospital affiliated to Kunming Medical University. At the same time, 156 cases of primary breast cancer were diagnosed as control group. The original medical records were collected in the medical records room, and the feasible indexes were fully considered through a large number of references. Unified data collection. The use of SPSS19.0 statistical software for statistics. Logistic regression analysis was used to study the risk factors related to atypical hyperplasia of breast and breast cancer. The risk factors related to atypical hyperplasia of breast to breast cancer were obtained. Occurrence provides the scientific basis. Results:. Age. Age of menarche, menopause and abortion are high risk factors of atypical hyperplasia of breast and breast cancer, especially age. Conclusion: the development of breast atypical hyperplasia to breast cancer is related to patient age, menarche age, menopause and abortion frequency. Therefore, preventive measures should be taken in these areas.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R737.9

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