本文關(guān)鍵詞：腫瘤中心晚期乳腺癌治療10年回顧性分析　出處：《吉林大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 晚期乳腺癌 轉(zhuǎn)移部位 綜合治療 生存率分析

【摘要】：目的:對(duì)777例吉林大學(xué)白求恩第一醫(yī)院腫瘤中心晚期乳腺癌患者的臨床病理特點(diǎn)、治療方法、轉(zhuǎn)移部位以及預(yù)后進(jìn)行回顧性分析,總結(jié)我中心晚期乳腺癌的轉(zhuǎn)移特點(diǎn),治療情況,探討影響晚期乳腺癌預(yù)后的危險(xiǎn)因素。方法:收集2007年1月至2016年12月于我院腫瘤中心進(jìn)行治療的晚期乳腺癌777例的基本資料,臨床病理特點(diǎn),各種治療手段以及預(yù)后和隨訪情況,完善晚期乳腺癌數(shù)據(jù)庫(kù),并進(jìn)行回顧性分析,應(yīng)用數(shù)據(jù)軟件進(jìn)行分析,了解晚期乳腺癌的復(fù)發(fā)轉(zhuǎn)移特點(diǎn),臨床治療情況,以及影響預(yù)后的危險(xiǎn)因素。結(jié)果:1.晚期乳腺癌一線化療藥物以紫杉醇為主,到2、3線治療是以紫衫、鉑類為主。2.晚期乳腺癌一線化療方案以紫杉醇+蒽環(huán)類為主,2線、3線治療是多種治療方案并存。3.晚期乳腺癌第一次復(fù)發(fā)時(shí)與初治時(shí)Ki-67、ER/PR、HER-2以及分子分型均有差異。并且復(fù)發(fā)后轉(zhuǎn)向更有浸潤(rùn)性以及較差預(yù)后的趨勢(shì)大。4.晚期乳腺癌第一次復(fù)發(fā)部位與分子分型和疾病分期相關(guān),Her-2過(guò)表達(dá)型易發(fā)生遠(yuǎn)處轉(zhuǎn)移,疾病分期較高易發(fā)生遠(yuǎn)處轉(zhuǎn)移。轉(zhuǎn)移器官個(gè)數(shù)與疾病復(fù)發(fā)風(fēng)險(xiǎn)相關(guān),復(fù)發(fā)風(fēng)險(xiǎn)越高,轉(zhuǎn)移器官個(gè)數(shù)越多。5.影響晚期乳腺癌3年總生存期的單因素分析結(jié)果顯示:病理類型、TNM分期、ER/PR、危險(xiǎn)度分級(jí)、組織學(xué)分級(jí)、轉(zhuǎn)移部位及轉(zhuǎn)移部位個(gè)數(shù)是影響3年OS的顯著因素(P0.05)。多因素分析顯示:ER/PR、轉(zhuǎn)移部位個(gè)數(shù)是影響乳腺癌患者預(yù)后的獨(dú)立危險(xiǎn)因素,ER/PR雙陽(yáng)性且轉(zhuǎn)移部位個(gè)數(shù)≤3的患者預(yù)后較好。結(jié)論:1.我中心晚期乳腺癌1年、3年、5年的生存率分別為90%、69%和55%,中位生存時(shí)間為78個(gè)月,ER/PR、轉(zhuǎn)移器官個(gè)數(shù)是影響晚期乳腺癌預(yù)后的獨(dú)立危險(xiǎn)因素。2.解剖學(xué)分期不能完全反映病人的預(yù)后,解剖學(xué)分期與腫瘤細(xì)胞生物性特性結(jié)合的功能分期是未來(lái)評(píng)估乳腺癌預(yù)后的指標(biāo)。3.晚期乳腺癌復(fù)發(fā)后病理參數(shù)可能會(huì)發(fā)生變化,且向惡性程度更高,侵襲更強(qiáng)的方向發(fā)展,因此二次活檢對(duì)于治療和預(yù)后分析有指導(dǎo)性意義。
[Abstract]:Objective: to retrospectively analyze the clinicopathological features, treatment methods, metastatic sites and prognosis of 777 patients with advanced breast cancer in the tumor center of Bai Qiuen first Hospital of Jilin University. To summarize the characteristics of metastasis and treatment of advanced breast cancer in our center. To investigate the risk factors affecting the prognosis of advanced breast cancer. Methods: from January 2007 to December 2016, we collected the basic data of 777 patients with advanced breast cancer who were treated in our hospital from January 2007 to December 2016. Clinicopathological features, treatment methods, prognosis and follow-up, improve the database of advanced breast cancer, and carry out retrospective analysis, data software analysis, to understand the characteristics of recurrence and metastasis of advanced breast cancer. Results 1. Paclitaxel was the main chemotherapeutic drug in advanced breast cancer. The first line chemotherapy regimen of advanced breast cancer is paclitaxel anthracycline 2 line 3 line treatment. 3. Advanced breast cancer is the first recurrence and the first treatment of Ki-67. ER/PR. HER-2 and molecular typing were different, and the tendency of turning to more invasive and poor prognosis after recurrence was greater. 4. The first recurrence site of advanced breast cancer was related to molecular classification and disease stage. Overexpression of Her-2 is prone to distant metastasis and disease stage is higher. The number of metastatic organs is related to the risk of disease recurrence, the higher the risk of recurrence. The number of metastatic organs. 5. The results of univariate analysis on the total survival time of 3 years of advanced breast cancer showed that the pathological type was TNM stage and ERP, risk grade, histological grade. Multivariate analysis showed that the number of metastatic sites was an independent risk factor for the prognosis of breast cancer patients, and the number of metastatic sites was a significant factor affecting the prognosis of breast cancer patients for 3 years (P0.051.Multivariate analysis showed that the number of metastatic sites was an independent risk factor for the prognosis of breast cancer patients. The prognosis of patients with ER/PR double positive and the number of metastatic sites 鈮，

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