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目的探究孕期及产后乳腺癌妇女的临床特征及生存状况。方法回顾性分析100例妊娠哺乳期乳腺癌患者的临床资料,根据患者的发病时期将患者分为哺乳期组和妊娠期组,各50例。所有患者均采用乳腺癌改良根治术进行治疗,探究孕期及产后乳腺癌妇女的临床特征及5年生存状况。结果哺乳期组患者的孕激素受体、腋窝淋巴结转移情况、三阴乳腺癌、原癌基因人类表皮生长因子受体2(HER-2)、新辅助化疗与和妊娠期组比较,差异均无统计学意义(χ~2分别=2.05、2.48、1.85、1.23、3.16,P均>0.05)。妊娠期组中肿瘤直径≥5 cm患者共36例(72.00%),明显高于哺乳期组27例(54.00%),Ki-67或PCNA阳性表达≥20%的患者共37例(74.00%),明显低于哺乳期组47例(94.00%),差异均有统计学意义(χ~2分别=6.46、4.48,P均<0.05)。哺乳期组术后1、2、3、4、5年的生存率与妊娠期组比较,差异均无统计学意义(χ~2分别=2.84、1.59、1.84、1.98、3.28,P均>0.05)。100例患者的5年总生存率为69.00%,5年无病生存率为58.00%。孕期及产后乳腺癌妇女总生存期和无病生存期的COX多因素分析显示,肿瘤大小、是否哺乳为患者总生存期的危险因素(RR分别=2.48、0.10,P均<0.05),也是无病生存期的危险因素(RR分别=3.18、0.36,P均<0.05)。结论孕期及产后乳腺癌妇女的生存状况较差,肿瘤大小和是否哺乳为影响患者生存状况的独立危险因素,妊娠哺乳期妇女应当加强预防乳腺癌的意识,早发现早治疗,提高生存率。
Objective To investigate the clinical characteristics and survival of women with breast cancer during pregnancy and postpartum. Methods The clinical data of 100 cases of breast cancer in pregnancy and lactation were retrospectively analyzed. The patients were divided into lactation group and pregnancy group according to the onset time of the patients, 50 cases in each group. All patients were treated with modified radical mastectomy to explore the clinical features and 5-year survival of women with breast cancer during pregnancy and postpartum. Results There were no significant differences in progesterone receptor, axillary lymph node metastasis, triple-negative breast cancer, HER-2, neoadjuvant chemotherapy and gestational age among lactation patients Statistical significance (χ ~ 2 = 2.05,2.48,1.85,1.23,3.16, P> 0.05). Thirty-six patients (72.00%) with gestational tumor≥5 cm in pregnancy group were significantly higher than those in lactation group (54.00%), 37 cases (74.00%) with Ki-67 or PCNA≥20% , Significantly lower than that in lactation group, 47 cases (94.00%), the differences were statistically significant (χ ~ 2 = 6.46,4.48, P <0.05). The survival rates at 1, 2, 3, 4 and 5 years after operation in lactation group were not significantly different from those in pregnancy group (χ ~ 2 = 2.84,1.59,1.84,1.98,3.28, P> 0.05 respectively) ). The 5-year overall survival rate of 100 patients was 69.00%, and the 5-year disease-free survival rate was 58.00%. Cox multivariate analysis showed that tumor size and breast-feeding were the risk factors of overall survival (RR = 2.48,0.10, P <0.05, respectively), and also had no effect on the overall survival and disease-free survival of pregnant women and postpartum women with breast cancer Disease risk factors for survival (RR = 3.18,0.36, P <0.05). Conclusion Pregnancy and postpartum women with breast cancer have poorer living conditions, tumor size and breastfeeding are independent risk factors affecting the survival of patients. Pregnancy and lactation women should strengthen their awareness of breast cancer prevention and early detection of early treatment and improve survival rate.