登录    
  
首页 > 期刊论文 > 论文摘要
pT1N0M0期Luminal B样乳腺癌的治疗及预后分析
         
Treatment and prognosis of pT1N0M0 Luminal B-like breast cancer

摘    要
目的:分析pT1N0M0期Luminal B样乳腺癌的临床病理特征、治疗方法及预后情况。 方法:收集2010年1月—2013年1月于天津医科大学肿瘤医院行手术治疗的300例pT1N0M0期Luminal B样乳腺癌患者的资料。采用χ2检验进行临床病理资料之间的比较,Kaplan-Meier法分析患者的生存情况,log-rank检验行单因素分析,COX比例风险回归模型进行预后的多因素分析。 结果:300例pT1N0M0期Luminal B样乳腺癌患者中,pT1aN0M0期24例(8%),pT1bN0M0期115例(38.3%),pT1cN0M0期161例(53.7%)。χ2检验分析结果显示,组织学分级与肿瘤大小相关(P=0.004)。单因素分析结果显示,发病年龄、组织学分级、人表皮生长因子受体2(human epidermal growth factor receptor-2,HER-2)表达、增殖细胞核相关抗原Ki-67阳性标记指数及化疗对患者的5年无疾病生存率有影响(P值均<0.05);HER-2表达状态与患者的5年总生存率相关(P<0.05)。多因素分析显示,组织学分级(P=0.048)、是否化疗(P=0.046)、HER-2表达状态(P=0.001)和Ki-67高低(P=0.002)是影响患者5年无病生存率的独立因素。进一步分析化疗方案与预后的关系,结果显示紫杉类/蒽环类单药化疗组与紫杉类联合蒽环类化疗组相比,pT1a-bN0M0期患者的5年无病生存率和总生存率无明显差异(P值均>0.05),而pT1cN0M0期患者紫杉类联合蒽环类化疗组的5年无病生存率明显优于紫杉类/蒽环类单药化疗组(P=0.042),但5年总生存率无明显差异(P=0.711)。 结论:术后辅助化疗可以改善pT1N0M0期Luminal B样乳腺癌患者的预后。对pT1a-bN0M0期患者可以给予紫杉类/蒽环类单药为主的化疗方案,而对pT1cN0M0期患者给予紫杉类联合蒽环类方案化疗预后更好。
标    签 乳腺肿瘤   抗肿瘤联合化疗方案   预后   Breast neoplasms   Antineoplastic combined chemotherapy protocols   Prognosis  
 
Abstract
Objective: To analyze the clinicopathological characteristics, treatment and prognosis of Luminal B-like breast cancer in pT1N0M0 stage. Methods: The data of 300 patients with stage pT1N0M0 Luminal B-like breast cancer who underwent surgery in Tianjin Medical University Cancer Institute and Hospital from January 2010 to January 2013 were collected. The clinicopathological characteristics, treatment and prognosis were retrospectively analyzed by using the statistical methods such as χ2 test, univariate analysis, COX multivariate analysis, Kaplan-Meier and so on. Results: In 300 cases of breast cancer, there were 24 cases (8%) in pT1aN0M0 stage, 115 cases (38.3%) in pT1bN0M0 stage, and 161 cases (53.7%) in pT1cN0M0 stage. Intergroup analysis (χ2 test) showed that only histological grade was related to tumor size (P = 0.004). Univariate analysis showed that age, histological grade, human epidermal growth factor receptor-2 (HER-2) expression, Ki-67 expression and chemotherapy had an effect on the five-year disease-free survival (DFS) of patients (all P < 0.05), and HER-2 was associated with five-year overall survival (OS) rate (P < 0.05). Multivariate analysis showed that histological grade (P = 0.048), chemotherapy (P = 0.046), HER-2 (P = 0.001) status and Ki-67 expression (P = 0.002) were independent factors of five-year DFS rate of the patients. The relationship between chemotherapy regimens and prognosis was further analyzed, and the results showed that five-year DFS rate and OS rate of the patients in pT1a-bN0M0 stage had no significant difference between taxane/anthracycline alone chemotherapy group and taxane combined with anthracycline group (both P > 0.05). For the patients in pT1cN0M0, the five-year DFS rate in taxane combined with anthracycline chemotherapy group was significantly higher than that in taxane/anthracycline alone chemotherapy group (P = 0.042), but the five-year OS rate was not significant different between the two groups (P = 0.711). Conclusion: Postoperative adjuvant chemotherapy can improve the prognosis of patients with stage pT1N0M0 Luminal B-like breast cancer. The patients in pT1a-bN0M0 stage may be given taxanes/anthraquinones chemotherapy for reducing overtreatment. For the patients in pT1cN0M0 stage, the prognosis will be better when the taxane combined with anthracycline chemotherapy is given.

中图分类号 R737.9   DOI 10.3781/j.issn.1000-7431.2018.33.258

 
  购买该论文  中国光学期刊网论文下载说明
      


所属栏目 临床研究

基金项目

收稿日期 2018/4/13

修改稿日期 2018/6/5

网络出版日期

作者单位点击查看


引用该论文: WANG Shixia,YANG Yanfang,LIU Jun. Treatment and prognosis of pT1N0M0 Luminal B-like breast cancer[J]. Tumor, 2018, 38(7): 689~696
王世霞,杨艳芳,刘 君. pT1N0M0期Luminal B样乳腺癌的治疗及预后分析[J]. 肿瘤, 2018, 38(7): 689~696


论文评价
共有人对该论文发表了看法,其中:
人认为该论文很差
人认为该论文较差
人认为该论文一般
人认为该论文较好
人认为该论文很好
分享论文
分享到新浪微博 分享到腾讯微博 分享到人人网 分享到 Google Reader 分享到百度搜藏分享到Twitter

参考文献
【1】FITZMAURICE C, DICKER D, PAIN A, et al. The global burden of cancer 2013[J]. Jama Oncology, 2015, 1(4):505-527.
 
【2】ZHENG S, BAI JQ, LI J, et al. The pathologic characteristics of breast cancer in China and its shift during 1999-2008: A national-wide multicenter cross-sectional image over 10 years[J]. Int J Cancer, 2012, 131(11):2622-2631.
 
【3】HART CD, SANNA G, SICLARI O, et al. Defining optimal duration and predicting benefit from chemotherapy in patients with luminal-like subtypes[J]. Breast, 2015, 24 Suppl 2:S136-S142.
 
【4】ALLGOOD PC, DUFFY SW, KEARINS O, et al. Explaining the difference in prognosis between screen-detected and symptomatic breast cancers[J]. Br J Cancer, 2011, 104(11):1680-1685.
 
【5】JOENSUU H, PYLKK?NEN L, TOIKKANEN S. Late mortality from pT1N0M0 breast carcinoma[J]. Cancer, 1999, 85(10):2183-2189.
 
【6】HANRAHAN EO, GONZALEZANGULO AM, GIORDANO SH, et al. Overall survival and cause-specific mortality of patients with stage T1a,bN0M0 breast carcinoma[J]. J Clin Oncol, 2007, 25(31):4952-4960.
 
【7】FISHER B, DIGNAM J, TANCHIU E, et al. Prognosis and treatment of patients with breast tumors of one centimeter or less and negative axillary lymph nodes[J]. J Natl Cancer Inst, 2001, 93(2):112-120.
 
【8】KENNEDY T, STEWART AK, BILIMORIA KY, et al. Treatment trends and factors associated with survival in T1aN0 and T1bN0 breast cancer patients[J]. Ann Surg Oncol, 2007, 14(10):2918-2927.
 
【9】SCHROEDER MC, LYNCH CF, ABU-HEJLEH T, et al. Chemotherapy use and surgical treatment by receptor subtype in node-negative T1a and T1b female breast cancers, Iowa SEER Registry, 2010-2012[J]. Clin Breast Cancer, 2015, 15(1):e27-e34.
 
【10】IGNATOV T, EGGEMANN H, BURGER E, et al. Management of small T1a/b breast cancer by tumor subtype[J]. Breast Cancer Res Treat, 2017, 163(1):1-8.
 
【11】Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100?000 women in 123 randomised trials[J]. Lancet, 2012, 379(9814):432-444.
 
【12】HOUVENAEGHEL G, GONCALVES A, CLASSE JM, et al. Characteristics and clinical outcome of T1 breast cancer: A multicenter retrospective cohort study[J]. Ann Oncol, 2014, 25(3):623-628.
 
【13】CHIA SK, SPEERS CH, BRYCE CJ, et al. Ten-year outcomes in a opulation-based cohort of node-negative, lymphatic, and vascular invasion-negative early breast cancers without adjuvant systemic therapies[J]. J Clin Oncol, 2004, 22 (9):1630-1637.
 
【14】GAMUCCI T, VACCARO A, CIANCOLA F, et al. Recurrence risk in small, node-negative, early breast cancer: A multicenter retrospective analysis[J]. J Cancer Res Clin Oncol, 2013, 139(5):853-860.
 
【15】李军楠, 刘晓东, 佟仲生. T1micN0M0、T1aN0M0和T1bN0M0乳腺癌376例临床特征和预后分析[J]. 肿瘤, 2011, 31(11):1026-1030.
 
【16】AZAMBUJA ED, CARDOSO F, CASTRO GD, et al. Ki-67 as prognostic marker in early breast cancer: a meta-analysis of published studies involving 12,155 patients[J]. Br J Cancer, 2007, 96(10):1504-1513.
 
相关信息
   标题 相关频次
 不同分子亚型乳腺浸润性小叶癌的临床特征及其预后
 7
 1~3个腋淋巴结阳性的T1~T2期乳腺癌改良根治术后患者预后因素分析
 4
 ⅠB期非小细胞肺癌中K-ras的表达对辅助化疗预后的影响
 4
 Ⅳ期乳腺癌:65例初诊患者的临床病理特征和预后
 4
 ERβ在乳腺癌中表达的意义
 4
 T1micN0M0、T1aN0M0和T1bN0M0乳腺癌376例临床特征和预后分析
 4
 白蛋白结合型紫杉醇治疗晚期乳腺癌的临床观察
 4
 成嗅神经细胞瘤36例的治疗及预后
 4
 初诊肝和(或)肺转移食管鳞癌患者的预后因素分析
 4
 多西他赛单药与联合方案一线治疗转移性乳腺癌的疗效及预后相关因素分析
 4
 肥胖对淋巴结阳性的乳腺癌患者总生存率的影响
 4
 肥胖与女性乳腺癌预后因素相关性的Meta分析
 4
 核因子E2相关因子2表达对晚期非小细胞肺癌一线含铂化疗疗效及预后影响的研究
 4
 化疗对三阴性乳腺癌CD44+CD24-/low细胞亚群的影响
 4
 甲磺酸伊马替尼治疗晚期胃肠间质瘤的疗效及预后因素
 4
 甲状腺癌的分子靶向治疗进展
 4
 局部晚期乳腺癌1081例临床病理特征及预后分析
 4
 康莱特注射液在乳腺癌新辅助化疗中的作用
 4
 可手术乳腺癌病人月经生育史与预后关系
 4
 内分泌治疗耐药的激素受体阳性晚期乳腺癌的治疗研究进展
 4
 年轻乳腺癌患者治疗后妊娠对其预后的影响:一项Meta分析
 4
 乳腺癌白介素8基因表达及其临床意义
 4
 乳腺癌肺转移117例临床病理特征及预后相关因素分析
 4
 乳腺癌患者免疫指标检测及其临床意义
 4
 乳腺癌卵巢转移:18例患者的临床特征及预后
 4
 乳腺癌肉瘤患者94例临床病理特征和预后分析
 4
 乳腺癌特殊部位转移68例临床特征及预后分析
 4
 乳腺癌纤溶分子标志物t-PA、u-PA表达的临床研究
 4
 乳腺癌中肿瘤相关巨噬细胞STAT3激活与多种细胞因子及预后因素有关
 4
 乳腺癌组织中CAP1的表达及其临床意义
 4

  热点专题


关于我们  |   联系我们  |   广告投放  |   《肿瘤》杂志社版权所有 《肿瘤》杂志社   © 中国 上海 2014.3
沪ICP备15036656号-2