早期三阴性乳腺癌术后辅助化疗疗效及预后分析

【摘要】 目的 探究T1N0M0期三阴性乳腺癌患者接受术后辅助化疗的疗效。方法 回顾性分析上海交通大学乳腺癌数据库2010～2020年的T1N0M0期三阴性女性乳腺癌患者数据。根据是否接受化疗，分为化疗组和未化疗组，对比两组的病理特征，采用Kaplan-Meier法进行生存预后分析。通过单因素及多因素Cox回归模型评估影响无病生存期（DFS）的预后因素。结果 共纳入305例T1N0M0期三阴性乳腺癌患者，化疗组223例，未化疗组82例。两组在年龄、生育情况、月经情况、既往乳腺疾病史、手术方式、手术部位和术后放疗方面差异无统计学意义（P>0.05）。而在组织学分级、病理类型、Ki-67及肿块大小方面差异有统计学意义（P<0.05）。Kaplan-Meier生存曲线分析显示，化疗组与未化疗组在无病生存期（P=0.180）和总生存期（P=0.084）方面差异无统计学意义。多因素Cox回归分析表明，乳房全切术及组织学分级三级是影响T1N0M0期三阴性乳腺癌DFS的独立危险因素（HR>1,P<0.05）。结论 T1N0M0期三阴性乳腺癌患者接受辅助化疗与否的疗效差异不明显，提示该类患者的化疗应个体化。乳房全切术和组织学分级三级的患者更易复发和转移。更多还原

【Abstract】 Objective To investigate the efficacy of adjuvant chemotherapy in patients with stage T₁N₀M₀ triple-negative breast cancer(TNBC after surgery.Methods A retrospective analysis was conducted on data from female patients with T₁N₀M₀ stage TNBC in the Shanghai Jiao Tong University Breast Cancer Database from 2010 to 2020.Patients were divided into chemotherapy and non-chemotherapy groups based on whether they received chemotherapy post-surgery,and the pathological characteristics of the two groups were compared.Kaplan-Meier method was used for survival prognosis analysis.Univariate and multivariate Cox regression models were applied to evaluate prognostic factors affecting disease-free survival（DFS）.Results A total of 305 patients with T₁N₀M₀ stage TNBC were included,with 223 in the chemotherapy group and 82 in the non-chemotherapy group.There were no statistically significant differences between the two groups in terms of age,reproductive history,menstrual history,history of breast disease,surgical methods,surgical sites,and postoperative radiotherapy（P>0.05）.However,there were statistically significant differences in histological grade,pathological type,Ki-67,and tumor size（P<0.05）.Kaplan-Meier survival curve analysis showed no statistically significant differences in DFS（P=0.180）and overall survival（OS）（P=0.084）between the chemotherapy and non-chemotherapy groups.Multivariate Cox regression analysis indicated that mastectomy and grade Ⅲ histology were independent risk factors affecting DFS in T₁N₀M₀ stage TNBC（HR>1,P<0.05）.Conclusion There was no significant difference in efficacy between T₁N₀M₀ stage TNBC patients who received adjuvant chemotherapy and those who did not, suggesting that chemotherapy for this group of patients should be individualized. Patients with whole mastectomy and grade Ⅲ histology are more likely to experience recurrence and metastasis.更多还原