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目的:回顾性分析隐匿性乳腺癌(occult breast cancer,OBC)患者的资料,初步探讨其临床病理特征及影响患者预后的因素。方法:收集四川大学华西医院肿瘤中心2001年10月至2016年6月收治的25例隐匿性乳腺癌的临床病理及治疗资料,采用Kaplan-Meier法计算生存率并绘制生存曲线,log-rank检验及COX回归分别进行单因素及多因素生存分析。结果:本组患者5年总生存率(overall survival,OS)为57.8%。雌激素受体(estrogen receptor,ER)阳性率48%,孕激素受体(progesterone receptor,PR)阳性率52%,人表皮生长因子受体2(human epithelial growth factor receptor 2,HER2)阳性率32%。单因素分析结果显示:PR状态、放疗、内分泌治疗及远处转移是可能影响预后的因素。多因素分析结果显示远处转移是唯一影响预后的因素,降低了患者总生存率(HR=0.131;95%CI,0.020~0.835;P=0.031)。结论:隐匿性乳腺癌发病率低,诊断困难,远处转移是影响预后的重要因素。手术、化疗、放疗、内分泌治疗和靶向治疗的综合治疗是提高隐匿性乳腺癌患者生存率的重要措施。
OBJECTIVE: To retrospectively analyze the data of patients with occult breast cancer (OBC) and to investigate the clinicopathological features and prognostic factors. Methods: The clinical data of 25 cases of occult breast cancer admitted to Cancer Center of West China Hospital of Sichuan University from October 2001 to June 2016 were collected. Survival rate and survival curve were calculated by Kaplan-Meier method. The log-rank test And COX regression respectively univariate and multivariate survival analysis. Results: The 5-year overall survival (OS) of this group was 57.8%. The positive rate of estrogen receptor (ER) was 48%, the positive rate of progesterone receptor (PR) was 52%, the positive rate of human epithelial growth factor receptor 2 (HER2) %. Univariate analysis showed that PR status, radiotherapy, endocrine therapy and distant metastasis were the possible prognostic factors. Multivariate analysis showed that distant metastasis was the only prognostic factor and decreased the overall survival (HR = 0.131; 95% CI, 0.020-0.835; P = 0.031). Conclusion: The incidence of occult breast cancer is low, diagnosis is difficult, distant metastasis is an important factor affecting the prognosis. Comprehensive treatment of surgery, chemotherapy, radiotherapy, endocrine therapy and targeted therapy is an important measure to improve the survival rate of occult breast cancer patients.