单中心25例隐匿性乳腺癌的临床病理特征及预后分析

摘要

目的:回顾性分析隐匿性乳腺癌(occult breast cancer,OBC)患者的资料,初步探讨其临床病理特征及影响患者预后的因素.方法:收集四川大学华西医院肿瘤中心2001年10月至2016年6月收治的25例隐匿性乳腺癌的临床病理及治疗资料,采用Kaplan-Meier法计算生存率并绘制生存曲线,log-rank检验及COX回归分别进行单因素及多因素生存分析.结果:本组患者5年总生存率(overall survival,OS)为57.8%.雌激素受体(estrogen receptor,ER)阳性率48%,孕激素受体(progesterone receptor,PR)阳性率52%,人表皮生长因子受体2(human epithelial growth factor receptor 2,HER2)阳性率32%.单因素分析结果显示:PR状态、放疗、内分泌治疗及远处转移是可能影响预后的因素.多因素分析结果显示远处转移是唯一影响预后的因素,降低了患者总生存率(HR=0.131;95%CI,0.020~0.835;P=0.031).结论:隐匿性乳腺癌发病率低,诊断困难,远处转移是影响预后的重要因素.手术、化疗、放疗、内分泌治疗和靶向治疗的综合治疗是提高隐匿性乳腺癌患者生存率的重要措施.%Objective: Retrospective analysis of occult breast cancer(OBC) patients with a preliminary study of clinical and pathological characteristics as well as prognostic factors.Methods: Twenty-five cases of OBC were collected in the Oncology Center of West China Hospital,Sichuan University,from October 2001 to June 2016.Kaplan-Meier method was used to calculate the survival rate and create survival curve.Log-rank test and COX regression model were separately utilized for univariate and multivariate analysis of overall survival (OS).Results: The 5-year OS was 57.8%.The positive rate of estrogen receptor (ER) was 48%,the progesterone receptor (PR) 52% and the human epithelial growth factor receptor 2 (HER2) 32%.Univariate analysis showed that PR status,radiotherapy,endocrine therapy and distant metastasis were potential prognostic factors.Multivariate analysis showed that the occurrence of distant metastasis was the only statistically significant factor which reduced the overall survival rate(HR=0.131;95%CI,0.020~0.835;P=0.031).Conclusion: The incidence of occult breast cancer is low and the diagnosis is difficult.Distant metastasis is an important prognostic factor.Combination therapy including surgery,chemotherapy,radiotherapy,endocrine therapy and targeted therapy is an important strategy to improve the overall survival of patients with occult breast cancer.