CAJ | 학술논문

目的：探讨隐性乳腺癌（隐性乳腺癌是指一类以腋窝淋巴结转移癌为表现的，临床查体和影像学检查均不能发现乳腺内病灶的特殊类型乳腺癌）治疗方案及预后的相关性。方法回顾性分析天津肿瘤医院1978年1月至2008年12月期间收治的205例隐性乳腺癌患者病例资料。结果入组的205例隐性乳腺癌患者随访时间最短4个月，最长158个月，中位随访时间为61个月。5年无病生存率63.5％，10年无病生存率为39.8％。中位无病生存时间为85个月。5年总生存率为79.8％，10年总生存率为49.4％。年龄、绝经情况、腋下肿物大小、腋窝转移灶的雌激素受体（ ER）、孕激素受体（PR）、人表皮生长因子受体2（HER-2）、淋巴结情况、手术治疗、有无新辅助化疗或辅助化疗、有无内分泌治疗、有无放疗均与隐性乳腺癌患者生存率有统计学关联，为隐性乳腺癌无病生存的影响因素。其中ER的表达情况、软组织浸润情况、有无新辅助化疗是影响隐性乳腺癌的独立预后因素（ P＜0.05）。结论 ER的表达情况、软组织浸润情况、有无新辅助化疗是影响隐性乳腺癌预后的独立因素。提示对于隐性乳腺癌患者应予新辅助化疗。
목적：탐토은성유선암（은성유선암시지일류이액와림파결전이암위표현적，림상사체화영상학검사균불능발현유선내병조적특수류형유선암）치료방안급예후적상관성。방법회고성분석천진종류의원1978년1월지2008년12월기간수치적205례은성유선암환자병례자료。결과입조적205례은성유선암환자수방시간최단4개월，최장158개월，중위수방시간위61개월。5년무병생존솔63.5％，10년무병생존솔위39.8％。중위무병생존시간위85개월。5년총생존솔위79.8％，10년총생존솔위49.4％。년령、절경정황、액하종물대소、액와전이조적자격소수체（ ER）、잉격소수체（PR）、인표피생장인자수체2（HER-2）、림파결정황、수술치료、유무신보조화료혹보조화료、유무내분비치료、유무방료균여은성유선암환자생존솔유통계학관련，위은성유선암무병생존적영향인소。기중ER적표체정황、연조직침윤정황、유무신보조화료시영향은성유선암적독립예후인소（ P＜0.05）。결론 ER적표체정황、연조직침윤정황、유무신보조화료시영향은성유선암예후적독립인소。제시대우은성유선암환자응여신보조화료。
Objective To explore the prognosis of occult breast cancer.Methods From January 1978 to December 2008, retrospective analyses were conducted for 205 female patients with axillary lymph node metastasis from an unknown primary source.Results During a median follow-up time of 61 (4-158) months, the 5 and 10-year rates of disease-free survival ( DFS) were 63.5%and 39.8%respectively.The median overall survival ( OS ) was 10 years.And the 5 and 10-year OS were 79.8% and 49.4%respectively.Significant differences existed in medical history , family history, estrogen receptor ( ER), human epidermal growth factor receptor-2(HER-2), infiltration of soft tissue, surgical option, neoadjuvant chemotherapy , chemotherapy , and radiotherapy with DFS of occult breast cancer ( P<0.05 ).The most important determinants of DFS and OS were ER , infiltration of soft tissue and neoadjuvant chemotherapy (P<0.05).Conclusion Radical mastectomy should be performed instead of modified radical mastectomy to improve the patient quality of life.