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目的探讨双侧原发性乳腺癌患者临床病理特征及预后。方法选取2007年1月-2009年12月于该院确诊并接受手术治疗的双侧原发性乳腺癌(bilateral primary breast cancer,BPBC,简称双乳癌)患者28例为研究对象,回顾性分析患者发病年龄、发病间隔、治疗方式、病理组织学、临床分期、激素受体、相关基因表达及生存率。结果以间隔12个月为判断异时性的时间标准,同时性双侧原发乳腺癌(s BPBC)患者9例,异时性双侧原发乳腺癌(m BPBC)患者19例。m BPBC组患者首发癌与对侧癌在绝经状态、术式选择和病理类型上差异有统计学意义(P<0.05),s BPBC组患者首发癌和对侧癌的临床分期差异有统计学意义(P<0.05)。在ER、PR和HER-2表达方面,组内首发癌与对侧癌比较,组间首发癌与对侧癌比较,差异均无统计学意义(均P>0.05)。m BPBC患者3年及5年的生存率高于s BPBC,但差异无统计学意义(P>0.05)。结论单侧乳腺癌患者,对侧乳腺癌发生的危险率逐年增加,应建立有效的随诊筛查制度,以期早期诊断、早期治疗,提高双侧乳腺癌患者的治愈率及生存率。
Objective To investigate the clinicopathological characteristics and prognosis of patients with bilateral primary breast cancer. Methods Twenty-eight patients with bilateral primary breast cancer (BPBC) who were diagnosed and undergone surgical treatment in our hospital from January 2007 to December 2009 were selected as the study subjects. The patients were retrospectively analyzed Age of onset, interval of onset, treatment, histopathology, clinical stage, hormone receptor, related gene expression and survival rate. The results were based on a time interval of 12 months to determine the timing of heterosexual events. Nine patients had simultaneous bilateral primary breast cancer (s BPBC) and 19 patients had synchronous bilateral primary breast cancer (m BPBC). m BPBC patients with primary cancer and contralateral cancer in menopausal status, surgical options and pathological types were significantly different (P <0.05), s BPBC group of patients with primary cancer and contralateral cancer clinical stage difference was statistically significant (P <0.05). In ER, PR and HER-2 expression, there was no significant difference between the first group and the contralateral group (P> 0.05). The 3-year and 5-year survival rates of patients with m BPBC were higher than those of s BPBC, but the difference was not statistically significant (P> 0.05). Conclusion In unilateral breast cancer patients, the risk of contralateral breast cancer is increasing year by year. An effective follow-up screening system should be set up to early diagnosis and early treatment and to improve the cure rate and survival rate of patients with bilateral breast cancer.