Pan Yuanxing, Lin Yunfei, Mi Chuan
Department of Orthopedics, Peking University First Hospital, Beijing, China.
Ann Transl Med. 2021 Aug;9(16):1340. doi: 10.21037/atm-21-4052.
A retrospective study was performed to summarize the clinicopathological characteristics of breast cancer patients with bone metastasis, to clarify the metastasis sites, and to explore the risk factors affecting prognosis.
Breast cancer patients with bone metastasis diagnosed in our hospital from January 2008 to January 2019 were included. Through follow-up by telephone call or return visit, the metastasis sites and clinicopathological characteristics were summarized. The risk factors influencing prognosis were analyzed by univariate and multivariate regression analyses.
Multifocal bone metastases were dominant in the 150 patients, and the metastatic rates in the spine, chest, pelvis, limbs, and skull were 75.3%, 74.0%, 56.0%, 46.7%, and 28.7%, respectively, with significant differences (P<0.01). Kaplan-Meier univariate analysis showed that age, menstrual status, number of metastatic lymph nodes, clinical stage, endocrine therapy, alkaline phosphatase level, visceral metastasis, and number of bone metastasis sites affected the overall survival. Cox multivariate regression analysis revealed that endocrine therapy, number of metastatic lymph nodes, visceral metastasis, number of bone metastasis sites, and c-erbB-2 expression were independent prognostic factors.
Middle-aged and elderly patients with breast cancer, mainly aged 40-60 years old, are prone to bone metastasis. The incidence rate of bone metastasis is high within 3 years after surgery, involving the spine, chest, pelvis, limbs, and skull in descending order. The number of metastatic lymph nodes, endocrine therapy, visceral metastasis, number of bone metastasis lesions at the first onset, and c-erbB-2 expression are independent prognostic factors influencing the survival rate of breast cancer patients with bone metastasis.
进行一项回顾性研究，以总结骨转移乳腺癌患者的临床病理特征，明确转移部位，并探讨影响预后的危险因素。
纳入2008年1月至2019年1月在我院诊断为骨转移的乳腺癌患者。通过电话随访或复诊，总结转移部位及临床病理特征。采用单因素和多因素回归分析对影响预后的危险因素进行分析。
150例患者中多灶性骨转移占主导，脊柱、胸部、骨盆、四肢和颅骨的转移率分别为75.3%、74.0%、56.0%、46.7%和28.7%，差异有统计学意义（P<0.01）。Kaplan-Meier单因素分析显示，年龄、月经状态、转移淋巴结数目、临床分期、内分泌治疗、碱性磷酸酶水平、内脏转移及骨转移部位数目影响总生存。Cox多因素回归分析显示，内分泌治疗、转移淋巴结数目、内脏转移、骨转移部位数目及c-erbB-2表达是独立的预后因素。
40～60岁的中老年乳腺癌患者易发生骨转移。术后3年内骨转移发生率高，转移部位依次为脊柱、胸部、骨盆、四肢和颅骨。转移淋巴结数目、内分泌治疗、内脏转移、初发时骨转移病灶数目及c-erbB-2表达是影响骨转移乳腺癌患者生存率的独立预后因素。
