【摘要】 目的:分析单一机构转移性乳腺癌(metastatic breast cancer,MBC)患者的临床病理特征及生存情况,并探讨影响预后的独立因素。方法:研究对象为2004年1月-2006年12月乳腺癌根治术后出现复发和转移并具备完整的病历和随访资料的280例MBC患者,对其临床病理特征、复发和转移情况以及生存情况进行回顾性分析。单因素生存分析采用Kaplan-Meier法,多因素预后分析采用COX比例风险模型。结果:本组患者中位无进展生存时间(progression-free survival,PFS)为9个月(1～93个月),中位总生存时间(overall survival,OS)为45个月(2～99个月),1、3和5年生存率分别为91.1%、59.5%和36.9%。单因素分析显示,病理类型、淋巴血管侵犯、激素受体(hormonal receptor,HR)状态、分子分型、无病生存时间(disease-free survival,DFS)、内脏转移、首次转移部位数目、肝转移、脑转移、解救内分泌治疗和解救放疗与OS相关(P<0.05)。多因素分析显示,淋巴血管侵犯、分子分型、内脏转移和肝转移是MBC患者预后的独立影响因素(P<0.05)。结论:淋巴血管侵犯、三阴型乳腺癌、内脏转移和肝转移是MBC患者不良预后的独立影响因素,对MBC患者的预后判断及个体化治疗具有重要的临床指导意义。更多还原

【Abstract】 Objective:To analyze the clinicopathological features and survival for patients with MBC (metastatic breast cancer) at a single institution, and to establish prognostic factors for MBC. Methods:A total of 280 female patients with MBC were recruited between January 2004 and December 2006 at a single institution previously receiving complete anticancer treatment and with accurate and complete clinical and follow-up information. The clinicopathological characteristics, the patterns of recurrence and metastasis and the survival were retrospectively analyzed. The univariate and multivariate analyses of prognosis were performed by Kaplan-Meier method and COX proportional-hazard regression model, respectively. Results:The median PFS (progression-free survival) was 9 months (1-93 months), the median OS (overall survival) after recurrence was 45 months (2-99 months), and the one-, three- and five-year survival rates were 91.1%, 59.5% and 36.9%, respectively. Univariate analysis showed that pathological type, lymphovascular invasion, hormone receptor status, molecular subtype, DFS (disease-free survival), visceral metastasis, the number of first metastatic sites, liver metastasis, brain metastasis, palliative endocrine therapy and palliative radiotherapy had significant impacts on the OS (P < 0.05). In the multivariate analysis, lymphovascular invasion, molecular subtype, visceral metastasis, and liver metastasis were independent prognostic factors (P < 0.05). Conclusion:The factors of lymphovascular invasion, triple-negative breast cancer, visceral metastasis and liver metastasis are independent predictors of poor prognosis. These fundamental observations may assist physicians in evaluating the survival potential and determining the appropriate therapeutic decision for patients with MBC.更多还原