摘要
目的分析比较青海地区汉族、藏族和回族乳腺癌患者的临床病理特征及生存数据,以掌握其特点、预后及影响因素。方法回顾性分析2011-01-01—2020-12-31青海大学附属医院收治的青海地区1101例女性乳腺癌患者临床病理资料,分析其临床、病理特征及预后情况;采用无病生存期(DFS)和总生存期(OS)进行预后评价,Kaplan-Meier法绘制生存曲线,Cox回归单因素和多因素分析预后影响因素。结果纳入患者中藏族(93例)、回族(89例)和汉族(919例)孕次分别为2(2~3)、2(2~3)和2(1~2)次;产次分别为2(1~2)、2(2~3)和2(1~2)次;绝经人数占比分别为24.73%(23/93)、35.96%(32/89)和44.94%(413/919);发现症状到就诊间隔时间>6个月的占比分别为41.94%(39/93)、33.71%(30/89)和27.20%(250/919)。3组患者孕次(χ^(2)=23.953,P<0.001)、产次(χ^(2)=39.400,P<0.001)、绝经情况(χ^(2)=15.814,P<0.001)及间隔时间(χ^(2)=9.961,P=0.007)差异均有统计学意义。与汉族相比,藏族患者间隔时间>6个月的比例较高(χ^(2)=8.984,P=0.003),肿物较大(χ^(2)=23.828,P<0.001),pTNMⅢ期构成比高(χ^(2)=6.365,P=0.012)及淋巴结转移数目多(χ^(2)=5.531,P=0.019);回族患者肿物较大(χ^(2)=12.602,P<0.001),组织学分级3级构成比高(χ^(2)=9.500,P=0.002)。入组病例5年DFS率和OS率分别为78.23%和83.40%,其中藏族患者5年DFS率(59.39%vs 80.05%)和OS率(66.28%vs 84.66%)低于汉族,差异有统计学意义,χ^(2)值分别为9.845和9.758,P值均为0.002;回族与汉族生存之间差异无统计学意义。Cox回归分析结果显示,民族是入组乳腺癌患者DFS和OS的独立影响因素,藏族与汉族相比,患者的死亡风险增加(HR=2.299,95%CI为1.269~4.166)。同时,肿物T_(2)~T_(4)(HR=1.686,95%CI为1.013~2.806)、淋巴结转移(HR=3.598,95%CI为1.781~7.269)和间隔时间>6个月(HR=1.260,95%CI为1.032~1.537)的患者乳腺癌死亡风险增加,是入组乳腺癌患者OS的独立影响因素。结论民族是青海地区女性乳腺癌患者�
Objective To analyze the clinicopathological characteristics and survival data of patients of the Han,Tibetan and Hui nationalities with breast cancer in Qinghai,so as to understand their characteristics,prognosis and prognostic factors.Methods According to the inclusion and exclusion criteria,the clinicopathological data of 1101female breast cancer patients admitted to the Affiliated Hospital of Qinghai University from Jan 1,2011to Dec 31,2020were retrospectively analyzed,and the clinical and pathological features and prognosis were analyzed.The prognosis was evaluated by disease-free survival(DFS)and overall survival(OS),the survival curve was drawn by Kaplan-Meier,and the prognostic factors were analyzed by Cox regression.Results We found the gravidities of the Tibetan nationality(93cases),the Hui nationality(89cases)and the Han nationality(919cases)breast cancer patients were 2(2-3),2(2-3)and 2(1-2)respectively,the parities were 2(1-2),2(2-3)and2(1-2),the proportions of menopause were 24.73%(23/93),35.96%(32/89)and 44.94%(43/109),and the constituent ratios of interval time from symptom to visit>6months were 41.94%(39/93),33.71%(30/89)and 27.20%(250/919).The differences in gravidity(χ^(2)=23.953,P<0.001),parity(χ^(2)=39.400,P<0.001),menopause(χ^(2)=15.814,P<0.001)and the interval time(χ^(2)=9.961,P=0.007)among these three groups were statistically significant.Compared with the Han nationality,the Tibetan nationality patients had a higher constituent ratios of interval time>6months(χ^(2)=8.984,P=0.003),larger tumors(χ^(2)=23.828,P<0.001),higher phaseⅢcomposition ratio of pTNM stage(χ^(2)=6.365,P=0.012)and more lymph node metastases(χ^(2)=5.531,P=0.019);the Hui nationality patients had large tumors(χ^(2)=2.602,P<0.001)and high histological grade 3constituent ratio(χ^(2)=9.500,P=0.002).Meanwhile,the 5-year DFS and OS survival rates of the enrolled patients were 78.23%and 83.40%,respectively.Although the difference in survival time between the people of Hui nationality and Han nationalities was not sig
作者
周晓峰
张英轸
任登峰
沈国双
赵久达
李占全
ZHOU Xiao-feng;ZHANG Ying-zhen;REN Deng-feng;SHEN Guo-shuang;ZHAO Jiu-da;LI Zhan-quan(Research Center for High Altitude Medicine,Key Laboratory of Ministry of Education for High Altitude Medicine,Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province(Qinghai-Utahjoint Research Key Laboratory for High Altitude Medicine),Qinghai University,Xining 810001,China;Affiliated Hospital of Qinghai University,Xining 810001,China;Medical College of Qinghai University,Xining 810001,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2022年第4期253-261,共9页
Chinese Journal of Cancer Prevention and Treatment
基金
青海省科技计划(2018-SF-113)
青海大学附属医院中青年科研基金(ASRF-2020-YB-05)
关键词
乳腺癌
病理特征
生存
预后
因素
breast cancer
pathological characteristics
survival,prognosis
factors
