Department of Breast and Thyroid Surgery.
Department of Plastic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, P.R. China.
Medicine (Baltimore). 2021 Jan 22;100(3):e24136. doi: 10.1097/MD.0000000000024136.
Currently, the wide-spread use of screening mammography has led to dramatic increases in ductal carcinoma in situ (DCIS). However, DCIS of Chinese Americans, the largest Asian subgroup in American, has rarely been comprehensively studied over the past decade. This work compared the DCIS characteristics and prognosis of Chinese American patients with White Americans in the USA to determine the characteristics and prognosis of DCIS patients of Chinese Americans.The data were obtained using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) data. The diagnosis and treatment variables between the two groups were compared by means of Chi-square tests. Survival was determined with the use of the Kaplan-Meier method and the multivariable Cox proportional hazard regression model.From 1975 to 2016, 81,745 White Americans and 2069 Chinese Americans were diagnosed with ductal carcinoma in situ. Compared with the white patients, the Chinese Americans were younger (P < .001) with smaller tumors (P < .001) and higher family income (P < .001). DCIS patients of Chinese American group accounted for a higher percentage of all breast cancers than the whites (P < .001). In the multivariable Cox proportional hazard regression analysis, Chinese American was an independent favorable prognostic factor in terms of overall survival (OS) (HR, 0.684; 95% CI, 0.593-0.789; P < .001) compared with the white group.In conclusion, DCIS characteristics of the Chinese group, which exhibited a higher proportion of younger age, a higher DCIS ratio, and a better prognosis, were distinct from those of the White Americans.
目前,广泛应用的筛查性乳房 X 光造影术导致原位导管癌(DCIS)的发病率显著上升。然而,在过去十年中,对于美国最大的亚裔群体——美籍华裔的 DCIS 却鲜有全面的研究。本研究通过比较美国美籍华裔和白种人患者的 DCIS 特征和预后,来确定美籍华裔 DCIS 患者的特征和预后。该研究的数据来自美国国家癌症研究所的监测、流行病学和最终结果(SEER)数据库。通过卡方检验比较两组之间的诊断和治疗变量。采用 Kaplan-Meier 法和多变量 Cox 比例风险回归模型确定生存情况。
1975 年至 2016 年,共诊断出 81745 例白种人和 2069 例美籍华裔的 DCIS 患者。与白人患者相比,美籍华裔患者更年轻(P<0.001),肿瘤更小(P<0.001),家庭收入更高(P<0.001)。与白人患者相比,美籍华裔 DCIS 患者占所有乳腺癌的比例更高(P<0.001)。在多变量 Cox 比例风险回归分析中,与白人组相比,美籍华裔是总生存期(OS)的独立预后良好因素(HR,0.684;95%CI,0.593-0.789;P<0.001)。
总之,与白种人相比,美籍华裔的 DCIS 特征表现为更年轻的比例更高、DCIS 比例更高、预后更好。