CAJ | 학술논문

背景与目的:中国男性乳腺癌的报道大多是小样本、回顾性研究,而分析影响患者预后因素的报道极少.本研究在相对比较大样本的中国男性乳腺癌资料基础上探讨影响患者预后的因素.方法:收集1969年1月至2009年3月在中山大学肿瘤防治中心经病理确诊、随访资料齐全的72例男性乳腺癌患者的临床资料.采用Kaplan-Meier方法、log-rank检验和Cox回归模型分析影响男性乳腺癌患者预后的因素.结果:本组男性乳腺癌患者的5年总生存率为72.4%.其中Ⅰ期100%,Ⅱ期74.2%、Ⅲ期57.2%、Ⅳ期0.单因素分析显示,肿瘤大小(P<0.001)、腋窝淋巴结转移(P=0.001)、TNM分期(P=0.001)、手术方式(手术和非手术比较:P<0.001;经典根治术和改良根治术比较:P=0.336)、有无内分泌治疗(P=0.02)是影响男性乳腺癌预后的因素.Cox多因素模型分析显示,TNM分期(P=0.035)、手术与否(P=0.021)、有无内分泌治疗(P=0.019)是影响预后的主要因素.结论:TNM分期、手术与否和有无内分泌治疗是影响中国男性乳腺癌预后的重要因素,提示早期发现和以手术为主、包含有内分泌治疗的综合治疗模式是提高男性乳腺癌患者生存率的关键手段之一.
배경여목적:중국남성유선암적보도대다시소양본、회고성연구,이분석영향환자예후인소적보도겁소.본연구재상대비교대양본적중국남성유선암자료기출상탐토영향환자예후적인소.방법:수집1969년1월지2009년3월재중산대학종류방치중심경병리학진、수방자료제전적72례남성유선암환자적림상자료.채용Kaplan-Meier방법、log-rank검험화Cox회귀모형분석영향남성유선암환자예후적인소.결과:본조남성유선암환자적5년총생존솔위72.4%.기중Ⅰ기100%,Ⅱ기74.2%、Ⅲ기57.2%、Ⅳ기0.단인소분석현시,종류대소(P<0.001)、액와림파결전이(P=0.001)、TNM분기(P=0.001)、수술방식(수술화비수술비교:P<0.001;경전근치술화개량근치술비교:P=0.336)、유무내분비치료(P=0.02)시영향남성유선암예후적인소.Cox다인소모형분석현시,TNM분기(P=0.035)、수술여부(P=0.021)、유무내분비치료(P=0.019)시영향예후적주요인소.결론:TNM분기、수술여부화유무내분비치료시영향중국남성유선암예후적중요인소,제시조기발현화이수술위주、포함유내분비치료적종합치료모식시제고남성유선암환자생존솔적관건수단지일.
Background and Objective:Male breast cancer(MBC)in China usually has been studied retrospectively with small sample size,and studies analyzing the prognostic factors are rare.This study was to investigate the prognostic factors of Chinese patients with MBC based on the data from a single institute with a relatively large sample.Methods: Clinical data of 72 patients with histopathologically confirmed MBC who received treatment at Sun Yat-sen University Cancer Center between January 1969 and March 2009,were collected.Kaplan-Meier,log-rank test and Cox regression model were used for statistical analysis.Results:The 5-year overall survival rate was 72.4%,and the survival rates for stage Ⅰ,Ⅱ,Ⅲ and IV were 100%,74.2%,57.2%and 0%,respectively.Univariate analysis showed that the tumor size(P<0.001),axillary lymph node status(P=0.001),TNM stage (P=0.001),operation model(with vs.without,P<0.001:classic radical reseclion vs.modified radical resection,P=0.336)and endocrine therapy(P =0.02) significantly influenced the survival. Multivariate Cox regression showed that TNM stage(P=0.035), operation model(P=0.021) and endocrine therapy(P=0.019)were independent prognostic factors for MBC.Conclusions:Early diagnosis and comprehensive treatment strategy consisting of surgery and endocrine treatment is essential to improve the survival of the patients with MBC,and TNM stage,operation and endocrine treatment are the significant prognostic factors for MBC.