【摘要】 目的：分析广州市乳腺癌患者内分泌治疗状况及其与预后的关系，强调合理内分泌治疗的重要性，为改善患者预后提供科学依据。方法：基于广州市乳腺癌队列研究人群的随访数据，描述乳腺癌一般人口学和临床病理特征及其与内分泌治疗的关系；分析不合理内分泌治疗随时间变化趋势；采用多因素COX比例风险回归模型分析乳腺癌患者的基线特征及不合理内分泌治疗与预后的关系。结果：本研究共纳入的3 257例乳腺癌患者中有505 (15.5%)例没有进行合理内分泌治疗，激素受体阴性患者（26.0%）较阳性患者（12.9%）不合理内分泌治疗的比例高，但随时间下降较快。激素受体阳性乳腺癌患者不合理内分泌治疗具有更高的死亡（HR=2.70, 95%CI:1.79～4.07）和疾病进展风险（HR=1.94, 95%CI:1.46～2.60）；激素受体阴性乳腺癌患者不合理内分泌治疗具有更高的疾病进展风险（HR=1.53, 95%CI:1.00～2.33）。结论：本研究的激素受体阳性患者不合理内分泌治疗的比例与其他国家和地区报道的水平相当，但激素受体阴性不合理内分泌治疗的比例偏高；激素受体阳性患者不合理内分泌治疗与较差的总生存期和无进展生存期相关，阴性患者不合理内分泌治疗与较差的无进展生存期相关；不合理内分泌治疗状况正在逐渐改善，但合理进行内分泌治疗的意识和行为有待于进一步加强。更多还原

【Abstract】 Objective :To analyze the status of endocrine therapy in breast cancer patients in Guangzhou and its relationship with prognosis, in order to emphasize the importance of appropriate endocrine therapy and provide scientific basis for improving the prognosis of patients. Methods :Based on the follow-up data of the breast cancer cohort in Guangzhou, the general demographic and clinicopathological characteristics of breast cancer and their relationship with endocrine therapy were described. The trend of inappropriate endocrine therapy over time was analyzed. A multivariate Cox proportional hazards regression model was used to analyze the relations of baseline characteristics and inappropriate endocrine therapy to the prognosis of breast cancer patients. Results: 505 of 3,257(15.5%) breast cancer patients included in this study did not receive appropriate endocrine therapy. The proportion of inappropriate endocrine therapy in hormone receptor-negative patients(26.0%) was higher than that in hormone receptor-positive patients(12.9%), and it declined rapidly over time. Hormone receptor-positive breast cancer patients with inappropriate endocrine therapy had a high risk of death(HR = 2.70, 95% CI: 1.79-4.07) and disease progression(HR = 1.94, 95% CI: 1.46-2.60); hormone receptor-negative patients with inappropriate endocrine therapy had a high risk of disease progression(HR = 1.53, 95% CI: 1.00-2.33). Conclusion: In this study, the proportion of hormone receptor-positive patients with inappropriate endocrine therapy is found to be similar to that reported in other countries and regions, but the proportion of hormone receptor-negative patients is higher. Inappropriate endocrine therapy is associated with poor overall survival(OS) and progression-free survival(PFS) in hormone receptor-positive breast cancer patients, and associated with poor PFS in hormone receptor-negative patients. Inappropriate endocrine therapy is gradually being corrected, and appropriate endocrine therapy should be further strengthened rationally and practically.更多还原