摘要
目的：探讨双侧原发性乳腺癌（ BPBC）的临床病理特征及其预后因素。方法回顾性分析2005年1月至2008年12月收治的133例BPBC患者的临床资料，并与同期收治的266例单侧原发性乳腺癌（UPBC）患者进行比较。结果 BPBC占同期乳腺癌患者的2．08％。 BPBC患者的初潮年龄、生育次数和绝经情况与UPBC患者比较，差异均有统计学意义（均P＜0．05）。 BPBC第二原发癌患者的肿块大小、病理类型、组织学分级和病理分期与UPBC患者比较，差异均有统计学意义（均P＜0．05）。 BPBC第一原发癌和BPBC第二原发癌患者的雌激素受体和人表皮生长因子受体2状态与UPBC患者比较，差异均有统计学意义（均P＜0．05）。 BPBC第二原发癌患者的孕激素受体状态与UPBC患者比较，差异均有统计学意义（均P＜0．05）。 Cox多因素分析结果显示，第一原发癌患者的绝经情况和第二原发癌患者的腋窝淋巴结状态为影响BPBC患者预后的独立因素（均P＜0．05）。 BPBC和UPBC患者的5年无病生存率分别为72．8％和79．3％，差异无统计学意义（P＞0．05）。 BPBC 和UPBC患者的5年总生存率分别为84．9％和89．8％，差异有统计学意义（P＝0．02）。结论 BPBC与UPBC患者的预后不同，第一原发癌时未绝经、第二原发癌腋窝淋巴结转移数≥10个为预后不良的独立因素。 UPBC术后患者为发生对侧乳腺癌的高危人群，应加强随访，以期做到早发现、早诊断和早治疗，改善预后。
Objective The aim of this study is to explore the clinicopathological characteristics, diagnosis, multidiscipline therapy and prognosis of bilateral primary breast cancer （BPBC）. Methods Clinical data of 133 patients with BPBC seen in Cancer Institute and Hospital of Tianjin Medical University from January 2005 to December 2008 were retrospectively analyzed and compared with those of 266 patients with unilateral primary breast cancer （UPBC）. Results BPBC accounted for 2.08% of all breast cancer cases. Compared with UPBC, BPBC patients had earlier menarche, more postmenopause disease and fewer fertility （ P〈0.05） . The T stage, pathological type, histological grade and tumor stage of the second tumor in BPBC patients were significantly different from those in UPBC cases （ P〈0.05） . The ER and HER-2 status of both the two tumors in BPBC and the PR status of the second tumor in BPBC were also significantly different from those in UPBC（ P〈0.05） . Besides, the menopause status when the first tumor happened and the lymph node metastasis status when the second tumor occurred were independent prognostic factors. There was no significant difference between the five-year disease free survival rates of UPBC and BPBC （ 79. 3% and 72.8%, P〉0.05）, but the 5-year overall survival rates of UPBC and BPBC had significant difference（89.8%and 84.9%, P=0.02） . Conclusions The prognosis of UPBC and BPBC has significant differences. If the patient is premenopause when the first tumor occurs or had more than ten metastatic axillary lymph nodes in patient with the second one, she has a poorer prognosis. The pationts who underwent unilateral breast radical＆amp;nbsp;mastectomy have an increased risk of contralateral breast cancer. In order to have early detection, diagnosis and treatment, we should strengthen the follow-up of the high risk patients.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2016年第4期289-293,共5页
Chinese Journal of Oncology
关键词
乳腺肿瘤
肿瘤
多原发性
病理学
临床
诊断
预后
Breast neoplasms
Neoplasms,multiple primary
Pathology,clinical
Diagnosis
Prognosis
