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目的了解汉中地区女性乳腺癌流行病学特征及诊治现状,为该地区乳腺癌的科学防治提供依据。方法于2013年1-12月收集汉中地区开展乳腺癌治疗的二级及以上综合医院、医保合作报销机构及汉中市两癌筛查办公室所登记的292例女性乳腺癌患者为研究对象,获取疾病特征与临床诊治资料。用SPSS 15.0统计软件包进行χ~2检验。结果 2013年汉中地区女性乳腺癌粗发病率为17.95/10万,标化发病率为18.74/10万,患者平均年龄为(47.7±3.6)岁,病例以农村患者为主(67.2%),三级医院收治率占65.1%;穿刺活检率为41.8%,三级医院进行术前穿刺活检率(51.8%)高于二级医院(23.5%),差异有统计学意义(χ~2=21.47,P<0.05)。病理类型以浸润性导管癌居多(89.0%);免疫组化以雌激素受体(ER)(+)/孕激素受体(PR)(+)比例最高,占35.9%;Ⅰ~Ⅱ期与Ⅲ~Ⅳ期患者间Ki-67的表达差异有统计学意义(P<0.05)。术式选择上以改良根治术为主(67.5%),保乳手术仅占7.8%,接受化疗的比例为70.5%,放疗及内分泌治疗的比例分别为27.4%和67.8%。结论汉中地区乳腺癌发病低于全国平均水平,该地区医疗资源分布不均匀,基层医院采取的辅助检查手段单一,术前病理确诊率及保乳术后比例低,辅助治疗欠规范。
Objective To understand the epidemiological characteristics and diagnosis and treatment of breast cancer in Hanzhong area and provide evidence for the scientific prevention and treatment of breast cancer in this area. Methods From January to December in 2013, 292 women with breast cancer who were enrolled in the second grade and above general hospital, medical cooperative reimbursement agency and Hanzhong Cancer Screening Office in Hanzhong area were enrolled in this study. Characteristics and clinical diagnosis and treatment information. SPSS15.0 statistical package for χ ~ 2 test. Results The incidence of breast cancer was 17.95 per 100,000 in Hanzhong area in 2013, with a standardized incidence rate of 18.74 per 100 000. The average age was 47.7 ± 3.6 years. There were 67.2% cases of rural patients, (65.1%), the biopsy rate was 41.8%, the preoperative biopsy rate in the tertiary hospitals was 51.8% (23.5%), the difference was statistically significant (χ ~ 2 = 21.47, P <0.05). The pathological type was mostly invasive ductal carcinoma (89.0%). Immunohistochemistry had the highest proportion of estrogen receptor (ER) / progesterone receptor (PR) (+), accounting for 35.9% The expression of Ki-67 in patients with stage Ⅲ ~ Ⅳ was significantly different (P <0.05). The main choice was modified radical mastectomy (67.5%), breast conserving surgery only 7.8%, chemotherapy 70.5% and radiotherapy and endocrine therapy 27.4% and 67.8% respectively. Conclusions The incidence of breast cancer in Hanzhong area is lower than the national average level. The distribution of medical resources in the area is not uniform. The methods of single laboratory examination, single diagnosis of preoperative pathological diagnosis and postoperative preservation of breast cancer are low, and the adjuvant therapy is not standardized.