Jayasinghe Upali W, Boyages John
New South Wales Breast Cancer Institute, University of Sydney, Westmead Hospital, New South Wales, Australia.
Breast. 2009 Feb;18(1):41-6. doi: 10.1016/j.breast.2008.10.004. Epub 2008 Nov 22.
Previous studies of patients with breast cancer have examined tumour location as a prognostic factor for survival with contradictory results. The current population-based study with 356 women examines the effect of tumour location and other important prognostic factors on survival. Univariate analyses indicated that central location (P<0.001), a larger pathological tumour size (P=0.003), number of positive lymph nodes (P<0.001), younger age at diagnosis (P=0.003), a more advanced TNM stage (P<0.001), a higher grade (P=0.016) and histologic type (P=0.011) were associated with a higher risk of breast cancer death. The 10-year survival of women with central location was 33%, compared to 73% for medial and 71% for lateral (P<0.001). However, the differences among tumour locations were markedly reduced after adjustment separately for early (P=0.39) and advanced (P=0.56) TNM stages, which also confirmed the results of multivariate analysis that the location does not influence survival after adjustment for other important clinicopathological characteristics.
先前针对乳腺癌患者的研究已将肿瘤位置作为生存的一个预后因素进行了检验，但结果相互矛盾。当前这项针对356名女性的基于人群的研究，考察了肿瘤位置及其他重要预后因素对生存的影响。单因素分析表明，肿瘤位于中央（P<0.001）、病理肿瘤尺寸较大（P=0.003）、阳性淋巴结数量（P<0.001）、诊断时年龄较轻（P=0.003）、TNM分期较晚（P<0.001）、分级较高（P=0.016）以及组织学类型（P=0.011）与乳腺癌死亡风险较高相关。肿瘤位于中央的女性10年生存率为33%，而位于内侧的为73%，位于外侧的为71%（P<0.001）。然而，在分别对早期（P=0.39）和晚期（P=0.56）TNM分期进行调整后，肿瘤位置之间的差异显著减小，这也证实了多因素分析的结果，即在校正其他重要的临床病理特征后，肿瘤位置并不影响生存。
