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目的回顾性分析女性炎性乳腺癌患者资料,初步探讨患者临床病理特征及影响预后的因素。方法收集2009年1月-2014年12月病理确诊、接受治疗、临床资料较完整的41例炎性乳腺癌患者的临床资料。采用对数秩检验和Cox回归分析影响炎性乳腺癌患者预后的因素。结果 41例炎性乳腺癌患者雌激素受体阴性率、孕激素受体阴性率和人类表皮生长因子受体2阳性率分别为58.5%、61.0%、34.2%。无疾病进展生存时间(PFS)为2~60个月,中位PFS为35个月,3年生存率为31.7%。单因素分析显示:TNM分期(P=0.016)、初始化学疗法(化疗)疗效(P=0.002)对PFS的影响有统计学意义。多因素分析显示:TNM分期(P=0.006)、初始化疗疗效(P=0.002)、表柔比星联合紫杉类化疗方案(P=0.041)均可影响患者预后。结论 TNM分期和初始化疗疗效是影响炎性乳腺癌预后的主要因素。蒽环类联合紫杉类的化疗方案优于其他方案。以化疗为主的多学科综合治疗模式是炎性乳腺癌患者的最佳治疗方案。
Objective To retrospectively analyze the data of female patients with inflammatory breast cancer and to explore the clinicopathological characteristics and prognostic factors of the patients. Methods The clinical data of 41 patients with inflammatory breast cancer who were confirmed by pathology, received treatment and had complete clinical data from January 2009 to December 2014 were collected. Log-rank test and Cox regression analysis were used to analyze the prognostic factors in patients with inflammatory breast cancer. Results The positive rates of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 in 41 patients with inflammatory breast cancer were 58.5%, 61.0% and 34.2% respectively. The progression-free survival time (PFS) was 2 to 60 months, the median PFS was 35 months, and the 3-year survival rate was 31.7%. Univariate analysis showed that the effect of TNM stage (P = 0.016) and initial chemotherapy (P = 0.002) on PFS was statistically significant. Multivariate analysis showed that TNM stage (P = 0.006), initial chemotherapy (P = 0.002), epirubicin combined with taxane chemotherapy (P = 0.041) all could affect the prognosis of patients. Conclusion TNM staging and initial chemotherapy are the main factors affecting the prognosis of inflammatory breast cancer. Anthracycline combined with taxane chemotherapy is superior to other programs. Chemotherapy-based multidisciplinary integrated treatment model is the best treatment for patients with inflammatory breast cancer.