CAJ | 학술논문

目的探讨直径≤2cm乳腺癌患者的预后影响因素，为指导个体化治疗及随访提供依据。方法收集2002年1月至2008年12月诊治的475例直径≤2 cm乳腺癌患者，收集完整临床病理资料和随访资料，采用Kaplan－Meier曲线法和Cox风险比例回归模型分析患者的无病生存率、总生存率的影响因素。结果发病年龄≤40岁（ P＝0．000）、腋窝淋巴结转移（ P＝0．000）、组织学分级为3级（P＝0．013）与5年无病生存率呈负相关；发病年龄≤40岁（P＝0．000）、腋窝淋巴结转移（P＝0．000）、组织学分级为3级（P＝0．012）、雌激素受体（ER）阴性（P＝0．035）与5年总生存率呈负相关。多因素分析显示，发病年龄≤40岁（HR＝3．249，95％CI：1．514～6．974，P＝0．002）、腋窝淋巴结转移（ HR＝3．177，95％CI：1．695～5．953，P＝0．000）是直径≤2 cm乳腺癌患者5年无病生存的独立危险因素；发病年龄≤40岁（HR＝5．006，95％CI：2．013～12．449，P＝0．001）、腋窝淋巴结转移（HR＝4．461，95％CI：1．948～10．218，P＝0．000）、ER阴性（HR＝2．612，95％CI：1．092～6．246，P＝0．031）是影响直径≤2 cm乳腺癌患者5年总生存率的独立预后因素。结论发病年龄≤40岁、腋窝淋巴结转移、ER阴性是影响直径≤2 cm乳腺癌复发、转移的危险因素，对于这部分患者应加强综合治疗和随访。
목적탐토직경≤2cm유선암환자적예후영향인소，위지도개체화치료급수방제공의거。방법수집2002년1월지2008년12월진치적475례직경≤2 cm유선암환자，수집완정림상병리자료화수방자료，채용Kaplan－Meier곡선법화Cox풍험비례회귀모형분석환자적무병생존솔、총생존솔적영향인소。결과발병년령≤40세（ P＝0．000）、액와림파결전이（ P＝0．000）、조직학분급위3급（P＝0．013）여5년무병생존솔정부상관；발병년령≤40세（P＝0．000）、액와림파결전이（P＝0．000）、조직학분급위3급（P＝0．012）、자격소수체（ER）음성（P＝0．035）여5년총생존솔정부상관。다인소분석현시，발병년령≤40세（HR＝3．249，95％CI：1．514～6．974，P＝0．002）、액와림파결전이（ HR＝3．177，95％CI：1．695～5．953，P＝0．000）시직경≤2 cm유선암환자5년무병생존적독립위험인소；발병년령≤40세（HR＝5．006，95％CI：2．013～12．449，P＝0．001）、액와림파결전이（HR＝4．461，95％CI：1．948～10．218，P＝0．000）、ER음성（HR＝2．612，95％CI：1．092～6．246，P＝0．031）시영향직경≤2 cm유선암환자5년총생존솔적독립예후인소。결론발병년령≤40세、액와림파결전이、ER음성시영향직경≤2 cm유선암복발、전이적위험인소，대우저부분환자응가강종합치료화수방。
Objective To study the prognostic parameters in patients with breast cancer of size smaller than or equal to 2 cm which are useful for treatment and follow-up.Methods Four hundred and seventy-five patients with breast cancer of size smaller than or equal to 2 cm diagnosed and treated in Affiliated Union Hospital, Fujian Medical University, China during the period from January, 2002 to December, 2008 were enrolled into the study.The clinical features, pathologic findings and follow-up data were analyzed.Kaplan-Meier curve method and Cox proportional hazard regression model were used to study factors which influenced disease-free survival and overall survival of the patients.Results Onset below 40 years of age (P=0.000), presence of axillary lymph node metastasis (P=0.000) and histologic grade 3 ( P=0.013 ) negatively correlated with 5-year disease-free survival.Onset below 40 years of age ( P =0.000), presence of axillary lymph node metastasis (P=0.000), histologic grade 3 (P =0.012) and negative estrogen receptor status (P=0.035) negatively correlated with 5-year overall survival.Multivariate analysis indicated that onset below 40 years of age ( HR=3.249, 95%CI:1.514-6.974, P=0.002) and presence of axillary lymph node metastasis (HR =3.177, 95% CI: 1.695 -5.953, P =0.000) were independent predictors of 5-year disease-free survival.Onset below 40 years of age ( HR=5.006, 95%CI:2.013-12.449, P=0.001), presence of axillary lymph node metastasis (HR=4.461, 95%CI:1.948-10.218, P=0.000) and negative estrogen receptor status ( HR=2.612, 95% CI:1.092-6.246, P=0.031) were independent predictors of 5-year overall survival.Conclusions Onset below 40 years of age, presence of axillary lymph node metastasis and negative estrogen receptor status are prognostic indicators in patients with breast cancer of size less than or equal to 2 cm.Assessment of these prognostic parameters would be helpful in treatment and follow-up of this group of breast cancer patients.