本文選題：三陰性乳腺癌　切入點(diǎn)：臨床病理特征　出處：《青海大學(xué)》2015年碩士論文

【摘要】：目的:探討三陰性乳腺癌在齊齊哈爾地區(qū)的臨床特點(diǎn)、病理特征、復(fù)發(fā)轉(zhuǎn)移率及生存情況,以便更深入地了解三陰性乳腺癌在齊齊哈爾地區(qū)的發(fā)生及發(fā)展規(guī)律,進(jìn)而為指導(dǎo)齊齊哈爾地區(qū)臨床醫(yī)師制定更為科學(xué)的、個(gè)體化的治療方案提供一定的幫助。方法:收集齊齊哈爾醫(yī)學(xué)院附屬第三醫(yī)院2008年1月1日-2009年12月31日經(jīng)手術(shù)治療的156例乳腺癌女性患者的臨床資料,其中經(jīng)病理學(xué)證實(shí)雌激素受體、孕激素受體和人類表皮生長(zhǎng)因子受體2為陰性的三陰性乳腺癌42例。臨床資料包括年齡、絕經(jīng)狀態(tài)、家族史、腫瘤大小、臨床分期、術(shù)前淋巴結(jié)情況、組織學(xué)分級(jí)、病理類型、化療方案、手術(shù)方式等;對(duì)其患者進(jìn)行必要的隨訪(電話隨訪、微信隨訪、醫(yī)生APP及信訪),以患者手術(shù)第一天為起點(diǎn),研究結(jié)局定為因腫瘤死亡,隨訪終點(diǎn)為患者死亡、失訪。到隨訪的截止時(shí)間其為止,死于其他的原因、跟蹤截止或者失訪仍生存者計(jì)為截尾值�；仡櫺苑治鯰NBC的臨床特點(diǎn)、病理特征、復(fù)發(fā)轉(zhuǎn)移以及生存情況,所有數(shù)據(jù)采用SPSS21.0統(tǒng)計(jì)軟件處理,臨床病理特征比較分析采用x2檢驗(yàn);患者生存情況用Kaplan-Meier方法進(jìn)行分析;兩組5年生存率比較用log-rank檢驗(yàn)。多因素分析采用Cox回歸分析,雙側(cè)檢驗(yàn),檢驗(yàn)水準(zhǔn)α㩳0.05。結(jié)果： 1.156例乳腺癌的患者中,42例的三陰性乳腺癌,占26.92%;2.三陰性乳腺癌及非三陰性乳腺癌都以年齡≥45歲、已絕經(jīng)無(wú)家族史、腫塊大小以≤5cm居多,但三陰性乳腺癌淋巴結(jié)狀態(tài)陽(yáng)性居多(64.29%),較非三陰性乳腺癌有顯著差異;三陰性乳腺癌浸潤(rùn)性導(dǎo)管癌占64.29%,與非三陰性乳腺癌相比較無(wú)統(tǒng)計(jì)學(xué)差異;3.三陰性乳腺癌與非三陰乳腺癌相比有較高復(fù)發(fā)轉(zhuǎn)移率(x2=5.095,P㩳0.05),其中以肺轉(zhuǎn)移多見(jiàn)(x2=5.200,P㩳0.05);4.生存情況:三陰性乳腺癌5年DFS、5年OS明顯低于非三陰性乳腺癌,預(yù)后不好;5.TNBC預(yù)后的單因素分析:年齡、術(shù)前淋巴結(jié)狀態(tài)、腫瘤大小、臨床分期和手術(shù)方式是影響DFS的單因素,腫瘤大小、臨床分期、淋巴結(jié)狀態(tài)和手術(shù)方式是影響5年OS的單因素;6.多因素分析:發(fā)現(xiàn)僅有年齡和淋巴結(jié)狀態(tài)才是影響5年DFS的獨(dú)立因素,而僅有腫瘤大小才是影響5年OS的獨(dú)立因素。結(jié)論： 1.三陰性乳腺癌占同期乳腺癌類型的26.92%;2.三陰性乳腺癌具有臨床分期晚、術(shù)前淋巴結(jié)陽(yáng)性多、組織學(xué)分級(jí)差的特點(diǎn);3.三陰性乳腺癌復(fù)發(fā)轉(zhuǎn)移率高,明顯肺轉(zhuǎn)移的特點(diǎn);4.三陰性乳腺癌比非三陰性乳腺癌生存時(shí)間短;5.年齡和淋巴結(jié)狀態(tài)是影響5年DFS的多因素,而腫瘤大小是影響5年OS的多因素。
[Abstract]:Objective: to investigate the clinical features, pathological features, recurrence and metastasis rate and survival status of triple negative breast cancer in Qiqihar, so as to understand the occurrence and development of triple-negative breast cancer in Qiqihar. In order to guide clinicians in Qiqihar region to formulate more scientific, Methods: the clinical data of 156 female breast cancer patients treated surgically from January 1, 2008 to December 31, 2009 in the third affiliated Hospital of Qiqihar Medical College were collected. Among them, 42 cases of breast cancer with negative estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 were confirmed by pathology. Clinical data included age, menopausal status, family history, tumor size, clinical stage. Preoperative lymph node status, histological grade, pathological type, chemotherapy regimen, operation method, etc., necessary follow-up (telephone follow-up, WeChat follow-up, doctor APP and letter visit), starting from the first day of operation. The outcome of the study was determined to be due to tumor death, and the end point of follow-up was death and loss of visit. To the deadline of follow-up, to die from other causes, follow-up cutoff or missing survivors were counted as amputation. The clinical features of TNBC were analyzed retrospectively. The pathological features, recurrence, metastasis and survival were analyzed by SPSS21.0 software, and the clinicopathological features were analyzed by x2 test, and the survival of the patients was analyzed by Kaplan-Meier method. The 5-year survival rate of the two groups was compared by log-rank test. Multivariate analysis was performed with Cox regression analysis, bilateral test, and test level 偽? Results: among the 1.156 patients with breast cancer, 42 cases (26.92%) had tri-negative breast cancer (26.92%) and non-triple-negative breast cancer (non-triple-negative breast cancer) were aged more than 45 years, had no family history after menopause, and the size of tumor was 鈮，

本文編號(hào)：1677364