| 余一雯,李 贺,曹 巍.不同生育史的女性乳腺癌患者临床特征及预后分析[J].中国肿瘤,2021,30(12):947-951. |
| 不同生育史的女性乳腺癌患者临床特征及预后分析 |
| Clinicopathologic Characteristics and Prognosis in Female Breast Cancer Patients with Different Number of Parity |
| 中文关键词 修订日期：2021-11-18 |
| DOI：10.11735/j.issn.1004-0242.2021.12.A011 |
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| 中文关键词: 乳腺癌 临床病理特征 净生存率 预后 生育史 |
| 英文关键词:breast cancer clinicopathologic characteristics survival rate prognosis parity |
| 基金项目:中国医学科学院医学与健康科技创新工程（2016?鄄I2M?鄄2?鄄004）； |
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| 中文摘要: |
| 摘 要：［目的］ 分析不同生育史女性乳腺癌患者的净生存率以及生育史与乳腺癌死亡风险的关系。［方法］ 回顾性收集北京市4所医院2006—2010年间北京户籍的女性乳腺癌患者首诊病例资料，共纳入有生育史信息的患者4 140例，同时对入组患者进行随访以获取全部患者的生存信息，随访截至2018年12月31日。采用SAS软件进行统计学分析，按生育史将乳腺癌患者分为4组（未生育，生育胎数=1，生育胎数=2，生育胎数≥3），比较4组的临床病理特征，并采用Kaplan-Meier法进行生存分析，Log-rank检验比较不同生育史组净生存率是否存在差异。最后采用单因素与多因素Cox比例风险模型分析不同生育史组患者乳腺癌死亡的风险。［结果］ 临床病理特征分析显示，育有≥3胎的患者乳腺癌复发或转移的概率最高（24.3%），且分子分型中诊断为三阴性乳腺癌的概率也最高（13.4%）。育有1胎、2胎、≥3胎的乳腺癌患者之间净生存率差异均有统计学意义，育有2胎的乳腺癌患者5年净生存率明显低于育有1胎的患者（P<0.001）。育有≥3胎的患者5年净生存率明显低于育有1胎（P<0.001）和2胎（P=0.015）的患者。诊断年龄在35～64岁之间并控制其他潜在混杂因素后Cox回归分析得出，生育胎数=2组相比生育胎数=1组（参考组）死亡风险增加54.4%（HR=1.544，95%CI：1.061～2.277）；生育胎数≥3组相比生育胎数=1组（参考组）死亡风险增加35.8%（HR=1.358，95%CI：0.650～2.839）。［结论］ 生育史是影响乳腺癌患者预后的独立危险因素，生育次数越多，乳腺癌生存率越低，诊断年龄在35～64岁之间，育有2胎的乳腺癌患者比育有1胎的患者，乳腺癌死亡风险更高。 |
| 英文摘要: |
| Abstract： ［Purpose］ To investigate the association between parity and prognosis in female breast cancer patients. ［Methods］ Clinical data of 4 140 female patients with breast cancer admitted to 4 hospitals in Beijing from 2006 to 2010 were retrospectively reviewed. The patients were followed till December 31， 2018 to obtain their survival data. The patients were divided into four groups according to the number of parity(0， 1， 2 and ≥3)， and the corresponding clinicopathologic characteristics were compared using SAS software. The survival of patients was analyzed with Kaplan-Meier method and Log-rank test was applied to compare the differences in survival rates among groups. The univariate and multivariate Cox proportional hazard models were applied to analyze the risk of breast cancer mortality. ［Results］ Patients with ≥3 parity had the highest probability of breast cancer recurrence/metastasis(24.3%)， and the highest probability of having triple-negative breast cancer(TNBC) subtype(13.4%). There were significant differences in breast cancer survival among parous women with different parity， and the 5-year survival rate was negatively correlated with the number of parity(P<0.05). In patients with the diagnosis age of 35~64 years， the multivariate Cox regression analysis showed that compared with women with a parity=1， those with a parity=2 and parity ≥3 had an increased breast cancer mortality(HR=1.544， 95%CI： 1.061～2.277; and HR=1.358， 95%CI： 0.650～2.839) respectively. ［Conclusion］ Parity is an independent risk factor for the prognosis of female breast cancer patients. Among the parous women， the breast cancer survival rate was negatively associated with the number of parity. |
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