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目的比较1981—2000年近20年间不同时期乳腺癌临床病理特点及预后情况,了解其发病和预后变化趋势。方法从天津医科大学附属肿瘤医院1981—2000年20年间收治的11400例乳腺癌病例中随机抽取1678例,对其临床病理及预后资料进行回顾性分析和比较。结果 1991—2000年(1990年代)和1981—1990年(80年代)相比,收治的乳腺癌病例数增加237%,平均每年上升11.8%;患者发病年龄未见明显变化,中位年龄为46～47岁;早期乳腺癌(0～Ⅰ期)的检出率提高,由1981—1985年的12%上升到1996—2000年的15.5%,而Ⅲ期乳腺癌的比例明显降低,由24.9%降至16.5%,原位癌比例由3.7%上升到4.4%;同时腋淋巴结转移率和局部复发及远处转移几率降低,分别由51.8%和27.8%下降到46.3%和13.5%;生存分析显示,患者术后5年及10生存率分别从1980年代的76%、63%提高到1990年代的86%和74%。结论近20年来乳腺癌发病率呈明显上升趋势,早期乳腺癌检出比例增加,腋淋巴结转移率和局部复发及远处转移几率降低,患者预后得到改善,5年、10生存率均有提高。
Objective To compare the clinicopathological characteristics and prognosis of breast cancer in different periods from 1981 to 2000 during the past 20 years and to understand the trend of its occurrence and prognosis. Methods A total of 1678 cases were randomly selected from 11400 cases of breast cancer admitted to Tumor Hospital Affiliated to Tianjin Medical University from 1981 to 2000, and the clinical, pathological and prognostic data were retrospectively analyzed and compared. Results The number of cases of breast cancer was increased by 237% from 1991 to 2000 (in the 1990s) and from 1981 to 1990 (up to the 1980s), with an average annual increase of 11.8%. There was no significant change in the onset age of patients with a median age of 46 ~ 47 years old; the detection rate of early stage breast cancer (stage 0 ~ Ⅰ) increased from 12% in 1981-1985 to 15.5% in 1996-2000, while the proportion of stage Ⅲ breast cancer decreased significantly from 24.9% To 16.5%, the proportion of carcinoma in situ increased from 3.7% to 4.4%, while the rates of axillary lymph node metastasis and local recurrence and distant metastasis decreased from 51.8% and 27.8% to 46.3% and 13.5%, respectively. Survival analysis showed that The 5-year and 10-year survival rates of patients increased from 76% and 63% respectively in the 1980s to 86% and 74% in the 1990s. Conclusion The incidence of breast cancer in the recent 20 years showed a clear upward trend. The detection rate of early breast cancer increased, the rate of axillary lymph node metastasis and local recurrence and distant metastasis decreased, and the prognosis of patients was improved. The 5-year and 10-year survival rates were all improved.