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目的:分析新疆地区2001—2010年可手术女性乳腺癌患者的临床病理特征和诊疗模式的演变趋势,为新疆地区乳腺癌防治工作提供临床依据。方法:采用系统随机抽样模式,回顾性分析新疆医科大学附属肿瘤医院2001—2010年1 024例可手术女性乳腺癌患者的临床病理资料和随访资料,对2001—2005年与2006—2010年的数据进行比较。结果:与2001—2005年相比,2006—2010年收治乳腺癌病例数增加215%。1 024例患者的平均发病年龄为47.80岁。2006—2010年早期乳腺癌(0~Ⅰ期)检出率(21.0%)较2001—2005年(16.2%)显著增加(P<0.05),而Ⅲ期乳腺癌占比显著下降(由30.6%降至19.0%)(P<0.05),原位癌占比则由3.2%上升至5.1%。2001—2005年腋窝淋巴结转移率为56.0%,2006—2010年下降至47.0%(P<0.05)。局部复发/远处转移率亦呈下降趋势,2001—2005年和2006—2010年分别为29.0%和22.7%(P<0.05)。术后5年总生存率和5年无病生存率分别由2001—2005年的79.7%和71.7%提高至2006—2010年的86.7%和77.3%(P值均<0.05)。乳腺癌改良根治术始终是主要的手术方式,2001—2005年和2006—2010年分别为81.1%和87.3%;保乳术占比逐渐增加,由2001—2005年的3.1%上升至2006—2010年的9.1%。接受新辅助化疗、术前空心针穿刺活检、免疫组织化学检测和荧光原位杂交技术检测患者的比例均呈上升趋势(P值均<0.05)。结论:2001—2010年,本院收治乳腺癌病例数显著增加。提高早期病例检出率以及规范化应用综合性诊疗措施是改善预后的关键。
OBJECTIVE: To analyze the clinicopathological characteristics and the trend of clinical diagnosis and treatment of female breast cancer from 2001 to 2010 in Xinjiang region, and to provide a clinical basis for the prevention and treatment of breast cancer in Xinjiang region. Methods: A systematic random sampling mode, retrospective analysis of Affiliated Tumor Hospital of Xinjiang Medical University, 2001-2010 January 024 cases of patients with operable breast cancer clinical and pathological data and follow-up data, from 2001 - data for 2010 - 2005 and 2006 Compare. Results: Compared with 2001-2005, the number of breast cancer cases treated in 2006-2010 increased by 215%. The average age of onset of 1,024 patients was 47.80 years. The detection rate of early stage breast cancer (stage 0 to stage Ⅰ) in 2006-2010 (21.0%) was significantly higher than that in 2001-2005 (16.2%) (P <0.05), while the proportion of stage Ⅲ breast cancer decreased significantly (from 30.6% To 19.0%) (P <0.05), and the proportion of carcinoma in situ increased from 3.2% to 5.1%. Axillary lymph node metastasis rate was 56.0% from 2001 to 2005, and decreased to 47.0% from 2006 to 2010 (P <0.05). The local recurrence / distant metastasis rate also showed a downward trend, which were 29.0% and 22.7% respectively in 2001-2005 and 2006-2010 (P <0.05). The 5-year overall survival and the 5-year disease-free survival rate increased from 79.7% and 71.7% in 2001-2005 to 86.7% and 77.3% in 2006-2010, respectively (all P <0.05). Modified radical mastectomy has been the major surgical modality, with 81.1% and 87.3% in 2001-2005 and 2006-2010, respectively; and the proportion of breast conserving surgery has been gradually increasing from 3.1% in 2001-2005 to 2006-2010 9.1% of the year. Neoadjuvant chemotherapy, preoperative hollow needle biopsy, immunohistochemical detection and fluorescence in situ hybridization detection of patients showed an upward trend (P all <0.05). Conclusion: From 2001 to 2010, the number of breast cancer cases in our hospital increased significantly. Improve the detection rate of early cases and standardize the application of comprehensive diagnosis and treatment measures is the key to improving prognosis.