陈倩欣,张怡心,李科,董航,许欢,林国桢,任泽舫.广州市2008-2017年全人群女性乳腺癌特征及其与预后的关系[J].中华流行病学杂志,2020,41(11):1831-1835 |
广州市2008-2017年全人群女性乳腺癌特征及其与预后的关系 |
Characteristics and prognosis of female breast cancer in Guangzhou, 2008-2017 |
收稿日期:2019-10-12 出版日期:2020-11-25 |
DOI:10.3760/cma.j.cn112338-20191012-00731 |
中文关键词: 乳腺癌 临床病理特征 预后 |
英文关键词: Breast cancer Clinicopathologic features Prognosis |
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中文摘要: |
目的 分析广州市女性乳腺癌患者基本人口学特征和临床病理特征及其与预后的关系。方法 利用广州市近十年肿瘤登记数据以及定期随访信息,描述女性乳腺癌基本人口学特征和临床病理特征的分布情况;采用Kaplan-Meier法计算研究对象1、3、5年总生存率;采用单因素和多因素Cox比例风险模型分析各变量与总生存期之间的关系。结果 广州市2008-2017年确诊的12 465名女性乳腺癌患者平均诊断年龄为53.9岁,40~54岁患者占比最高,为43.9%;仅15.6%患者为大专及以上文化程度;正常BMI患者占78.2%;90.0%的患者接受了手术治疗;浸润性导管癌是最常见组织学类型,占82.3%。4家三甲医院患者中,有2 640例纳入临床病理分析,其中临床早期(0-Ⅰ期)患者比例为35.0%,Ⅱ期占44.8%,Ⅲ、Ⅳ期各占17.2%、3.0%;ER阳性、PR阳性、HER-2阳性患者比例分别为79.5%、70.8%、19.2%;亚型方面,Luminal B亚型患者比例最高,为53.3%。1、3、5年总生存率分别为99.0%、95.3%、92.1%。Cox多因素分析结果显示诊断年龄≥55岁、TNM晚期、ER阴性、PR阴性、Luminal B亚型以及三阴性亚型与患者预后较差相关。结论 与我国既往以医院为基础的研究相比,本研究以广州市全人群为基础,发现乳腺癌患者高龄、临床早期、ER阳性患者占比较高;总生存率高于我国既往报道的水平;乳腺癌特征与预后关系和其他报道结果一致。 |
英文摘要: |
Objective To describe the distributions of demographic and clinic pathological characteristics and relations with survival on female breast cancer patients in Guangzhou from 2008 to 2017. Methods The baseline information of the subjects was obtained from the Guangzhou cancer registry and the outcomes were from the Cancer Follow-up System of Guangzhou. Kaplan-Meier was used to calculate the 1-, 3-, 5-year overall survival rates. Univariate and multivariate Cox proportional hazards regression models were used to identify the factors related to the overall survival. Results Among the 12 465 breast cancer patients recruited in the study, the average age at diagnosis was 53.9 years old, with those aged 45 to 54 making up the largest proportion (43.9%). Only 15.6% of the patients had college or above degrees. Patients with normal BMI accounted for 78.2%. Most of the patients (90.0%) had received surgical treatment. Invasive ductal carcinoma appeared the most common histologic type, accounting for 82.3%. Among the 2 640 patients diagnosed in the four large hospitals, clinical stages 0-Ⅰ, Ⅱ, Ⅲ and Ⅳ accounted for 35.0%, 44.8%, 17.2% and 3.0%, respectively. The proportions of ER-positive, PR-positive and HER-2 positive breast cancer were 79.5%, 70.8%, and 19.2%, respectively. In terms of subtypes, Luminal B was the most common one, accounted for 53.3%. The 1-, 3- and 5-year overall survival rates were 99.0%, 95.3% and 92.1%, respectively. Results from the multivariate analysis indicated that factors as: age over 55 years old at diagnosis, advanced TNM stage, ER negative, PR negative, Luminal B subtype and triple-negative subtype were associated with poorer prognosis. Conclusions Compared with the previous hospital-based studies in China, this population-based study revealed that the proportions of patients with advanced age, early clinical stage or ER positive breast cancer were relatively high and the overall survival rate for breast cancer was higher than that in the previous studies. Relationships between characteristics and prognosis of breast cancer were consistent with the previous findings. |
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