CAJ | 학술논문

目的评价规范化治疗后不同TNM分期乳腺癌患者的生命质量,以及欧洲五维健康量表(EQ-5D)在中国乳腺癌患者生命质量测评中的应用价值.方法采用国内乳腺癌患者生命质量测定调查量表(QLICP-BR)和EQ-5D中文版,分别测量于6个月前完成规范化治疗(内分泌治疗除外)的乳腺癌患者生命质量.采用x2检验、单因素方差分析、协方差分析等统计学方法分析影响乳腺癌患者生命质量的因素.以QLICP-BR量表中共性模块(QLICP-GM)的得分和QLICP-BR总分为标准,采用Pearson相关分析评价EQ-5D量表的应用价值.结果 2010年3-9月共收集符合纳入排除标准的女性乳腺癌患者178例,其中0期和Ⅰ期47例,Ⅱ期81例,Ⅲ期和Ⅳ期50例.控制年龄、文化程度、职业、出生地(城市和农村)、家庭月收入、医保支付情况后,0期和Ⅰ期患者调整QLICP-BR总分为(72.55±3.10)分,Ⅱ期患者为(64.09±2.69)分,Ⅲ期和Ⅳ期患者为(58.21 ±3.00)分,不同TNM分期患者调整QLICP-BR总分差异有统计学意义(P =0.002).0期和Ⅰ期患者的QLICP-BR总分和社会功能调整生命质量得分均高于Ⅱ期患者(均P＜0.05)；0期和Ⅰ期患者的QLICP-BR总分、特异模块、心理功能、社会功能和躯体功能调整生命质量得分均高于Ⅲ期和Ⅳ期患者(均P ＜0.05).不同TNM分期乳腺癌患者EQ-5D效用得分与相应的QLICP-GM得分和QLICP-BR总分均呈正相关(均P＜0.05).结论 TNM分期早的患者生命质量较好,早诊早治可以提高乳腺癌患者的生命质量.EQ-5D量表对不同TNM分期患者生命质量的测定有良好的区分度,可用于中国女性乳腺癌患者生命质量的评价.
목적 평개규범화치료후불동TNM분기유선암환자적생명질량,이급구주오유건강량표(EQ-5D)재중국유선암환자생명질량측평중적응용개치.방법 채용국내유선암환자생명질량측정조사량표(QLICP-BR)화EQ-5D중문판,분별측량우6개월전완성규범화치료(내분비치료제외)적유선암환자생명질량.채용x2검험、단인소방차분석、협방차분석등통계학방법분석영향유선암환자생명질량적인소.이QLICP-BR량표중공성모괴(QLICP-GM)적득분화QLICP-BR총분위표준,채용Pearson상관분석평개EQ-5D량표적응용개치.결과 2010년3-9월공수집부합납입배제표준적녀성유선암환자178례,기중0기화Ⅰ기47례,Ⅱ기81례,Ⅲ기화Ⅳ기50례.공제년령、문화정도、직업、출생지(성시화농촌)、가정월수입、의보지부정황후,0기화Ⅰ기환자조정QLICP-BR총분위(72.55±3.10)분,Ⅱ기환자위(64.09±2.69)분,Ⅲ기화Ⅳ기환자위(58.21 ±3.00)분,불동TNM분기환자조정QLICP-BR총분차이유통계학의의(P =0.002).0기화Ⅰ기환자적QLICP-BR총분화사회공능조정생명질량득분균고우Ⅱ기환자(균P＜0.05)；0기화Ⅰ기환자적QLICP-BR총분、특이모괴、심리공능、사회공능화구체공능조정생명질량득분균고우Ⅲ기화Ⅳ기환자(균P ＜0.05).불동TNM분기유선암환자EQ-5D효용득분여상응적QLICP-GM득분화QLICP-BR총분균정정상관(균P＜0.05).결론 TNM분기조적환자생명질량교호,조진조치가이제고유선암환자적생명질량.EQ-5D량표대불동TNM분기환자생명질량적측정유량호적구분도,가용우중국녀성유선암환자생명질량적평개.
Objective To evaluate the quality of life (QOL) in patients with breast cancer at different TNM stages and to estimate the value of EuroQol Five Dimension Indicator (EQ-5D) in measuring QOL among Chinese breast cancer patients.Methods A survey with Quality of Life Instruments for Cancer Patients-Breast Cancer (QLICP-BR) and EQ-5D was undertaken in breast cancer patients who had completed their standardized treatment (except for the endocrine treatment) six months ago.Chi-square test,one-way ANOVA,and covariance analysis were used to evaluate the possible factors influencing the QOL of breast cancer patients.Simultaneously,with the results of Quality of Life Instruments for Cancer PatientsGeneral Module (QLICP-GM,which is included in QLICP-BR.) and the total scores of QLICP-BR as standard,we conducted Pearson correlation analysis to evaluate the value of EQ-5 D.Results A total of 178 female breast cancer survivors were collected from March 2010 to September 2010.There were 47 cases (26.4％) at stage 0 and Ⅰ,81 cases (45.5％) at stage Ⅱ,and 50 cases (28.1％) at stage Ⅲ and Ⅳ.The total standardized score of QLICP-BR was 72.55 ± 3.10 in patients at stage 0 and Ⅰ,64.09 ± 2.69 in patients at stage Ⅱ and 58.21 ±3.00 in patients at stage Ⅲ and Ⅳ.The total standardized score of QLICP-BR and social domain of patients at stage 0 and Ⅰ were higher than patients at stage Ⅱ (all P ＜ 0.05).The total standardized score of QLICP-BR,specific domain of breast cancer,psychological,social and physical domains of patients at stage 0 and Ⅰ were higher than patients at stage Ⅲ and Ⅳ (all P ＜ 0.05).Covariance analysis showed that QOL standardized scores were significantly different across TNM stages when age,degree of education,birth place (metropolis or rural),occupation,domestic income,and medical insurance were controlled (P =0.002).Correlation analysis indicated that EQ-5D has a positive correlation with QLICP-GM and QLICP-BR (all P ＜ 0.05).Conclusions QOL of patients with early stage breast cancer is better than those at late stage.Early diagnosis and treatment can improve QOL of breast cancer patients.Chinese version of EQ-5D can well detect the differences of QOL among patients with different TNM stages,which can be used for evaluating QOL in Chinese female breast cancer patients.