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目的:分析苏州女性乳腺癌的临床特点和预后因素。方法:1 150例病例来自苏州地区1999-2005年诊断的女性乳腺癌,采用观察临床特点、生存率、死亡危险比、χ2检验和拟合多因素Cox比例风险回归模型等进行单因素和多因素分析,评估各种预后因素与乳腺癌的联系强度。结果:淋巴结转移与肿块大小、部位均有显著相关性,P均<0.01。苏州女性乳腺癌中年轻患者和Ⅰ期患者的比例有逐年上升的趋势,且年轻患者的腋淋巴结转移率、c-erbB-2阳性率较高,P均<0.05。发现疾病的方式、患者的文化程度、就诊时间与初诊时的临床分期有关,P均<0.05。单因素分析显示,患者年龄、肿瘤大小、TNM临床分期、腋淋巴结转移、肿瘤部位、c-erbB-2、ER和治疗方式等因素与乳腺癌患者生存率有关。多因素分析显示,淋巴结转移、治疗方式和c-erbB-2与生存率有关。结论:近年来苏州女性乳腺癌的诊断和治疗水平有所提高,接受综合治疗的患者生存率较高。腋淋巴结状况是评估预后的最主要指标,检测c-erbB-2有助于筛选高危患者。
Objective: To analyze the clinical characteristics and prognosis of female breast cancer in Suzhou. Methods: A total of 1 150 cases of breast cancer were diagnosed in women from 1999 to 2005 in Suzhou. Single factor and multifactorial factors were observed by observing clinical features, survival rate, risk of death, χ2 test and fitting multivariate Cox proportional hazards regression model. Analyze and assess the association between various prognostic factors and breast cancer. Results: There was a significant correlation between lymph node metastasis and tumor size and site (P <0.01). The proportion of young women with stage Ⅰ disease in Suzhou female breast cancer has been increasing year by year. The positive rate of axillary lymph node metastasis and c-erbB-2 in younger patients is higher (P <0.05). The way of finding the disease, the level of education of the patient, the time of visiting the patient were related to the clinical stage of the first visit, P <0.05. Univariate analysis showed that age, tumor size, TNM clinical stage, axillary lymph node metastasis, tumor site, c-erbB-2, ER and treatment and other factors with the survival rate of breast cancer patients. Multivariate analysis showed that lymph node metastasis, treatment and c-erbB-2 were associated with survival. Conclusion: The diagnosis and treatment of breast cancer in Suzhou women have been improved in recent years. The survival rate of patients receiving combined treatment is higher. Axillary lymph node status is the most important predictor of prognosis. Detection of c-erbB-2 helps screen for high-risk patients.