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目的探讨影响乳腺癌患者总体生存率相关的危险因素,为乳腺癌防治和预后提供参考。方法应用KaplanMeier法、Log-rank检验和Cox多元回归模型分析东莞市人民医院1 706例乳腺癌患者年龄、居住地、手术情况和肿瘤TNM分期与患者总体生存率的关系。结果 1 706例乳腺癌患者平均生存期为133个月,中位生存期为163个月。不同因素患者组中位生存期比较,非手术组患者(119个月)低于手术患者组(139个月)(χ~2=41.27,P<0.001);TNM高分期组患者(101个月)低于低分期的患者组(146个月)(χ~2=135.47,P<0.001);发病高年龄组(≤50岁)患者(143个月)低于低年龄组(>50岁)患者(125个月)(χ~2=35.04,P<0.001)。多因素Cox回归模型分析结果表明,未选择手术、肿瘤TNM高分期、和发病高年龄是乳腺癌总体生存率降低的独立危险因素。结论尽可能选择手术治疗,争取肿瘤早发现和关注高龄人群的康复保健工作是提高乳腺癌患者生存期的有效措施。
Objective To investigate the risk factors related to the overall survival of patients with breast cancer and to provide reference for the prevention and prognosis of breast cancer. Methods The Kaplan Meier method, Log-rank test and Cox multiple regression model were used to analyze the relationship among age, residence, operation, TNM stage and overall survival rate of 1 706 breast cancer patients in Dongguan People’s Hospital. Results The average survival time of 1 706 breast cancer patients was 133 months and the median survival time was 163 months. Patients in the non-surgical group (119 months) were lower than those in the surgical group (139 months) (χ ~ 2 = 41.27, P <0.001); patients in the TNM high-grade group (101 months (Χ ~ 2 = 135.47, P <0.001); patients with high morbidity (≤50 years) (143 months) were lower than those with younger age (> 50 years) Patients (125 months) (χ ~ 2 = 35.04, P <0.001). Multivariate Cox regression model analysis showed that non-surgical selection, TNM staging of tumors, and high incidence of age were the independent risk factors for overall survival of breast cancer. Conclusion It is an effective measure to improve the survival of patients with breast cancer by selecting surgical treatment as much as possible and seeking rehabilitation and health care of early detection and attention of elderly people.