年龄与女性乳腺癌预后呈U型关系：一项队列研究。
Age has a U-shaped relationship with breast cancer outcomes in women: a cohort study.
作者信息
Xie Yujie, Deng Yongqing, Wei Suosu, Huang Zhen, Li Lihui, Huang Kai, Wei Chunyu, Xu Jinan, Dong Lingguang, Zhang Qiuhuan, Zhao Jiehua, Zou Quanqing, Yang Jianrong
机构信息
Department of Breast and Thyroid Surgery, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
The Family Planning Office of Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
出版信息
Front Oncol. 2023 Oct 4;13:1265304. doi: 10.3389/fonc.2023.1265304. eCollection 2023.
BACKGROUND AND OBJECTIVES
Age is a significant determinant of susceptibility to breast cancer. Currently, the available evidence regarding the non-linear correlation between the age of diagnosis and the prognosis of breast cancer patients is contradictory. Insufficient data currently exist regarding the influence of age at diagnosis on the prognosis of breast cancer. The objective of our investigation was to examine the relationship between age at diagnosis and overall survival (OS), breast cancer-specific survival (BCSS), and disease-free survival (DFS).
METHODS
This retrospective cohort study included 1054 patients diagnosed with breast cancer between March 7, 2013 and December 31, 2019. The hazard ratios (HRs) and 95% confidence interval (CI) for OS, BCSS, DFS were assessed using Cox proportional hazard ratio models and restricted cubic splines (RCS).
RESULTS
The study included 1054 breast cancer patients who met the criteria. With a median follow-up of 4.86 years, 71 patients (6.74%) died and 144 patients (13.66%) relapsed. After multivariable adjustment, age showed a U-shaped association with OS, BCSS, and DFS, with significantly higher risk at two ends, with age inflection points of 44, 44, and 41 years for OS, BCSS, and DFS, respectively. For OS, Quartile 1 (HR, 2.09; 95% CI: 0.90-4.84), Quartile 3 (HR, 2.44; 95% CI: 1.05-5.65) and Quartile 4 (HR, 3.38; 95% CI: 1.51-7.54) had poorer OS compared with Quartile 2. Similar results were found for BCSS and DFS.
CONCLUSIONS
This study confirmed a U-shaped association between age at diagnosis and breast cancer outcome.
背景与目的
年龄是乳腺癌易感性的一个重要决定因素。目前，关于诊断年龄与乳腺癌患者预后之间非线性相关性的现有证据相互矛盾。目前关于诊断时年龄对乳腺癌预后影响的数据不足。我们研究的目的是探讨诊断时年龄与总生存期（OS）、乳腺癌特异性生存期（BCSS）和无病生存期（DFS）之间的关系。
方法
这项回顾性队列研究纳入了2013年3月7日至2019年12月31日期间确诊为乳腺癌的1054例患者。使用Cox比例风险模型和限制性立方样条（RCS）评估OS、BCSS、DFS的风险比（HRs）和95%置信区间（CI）。
结果
该研究纳入了1054例符合标准的乳腺癌患者。中位随访4.86年，71例患者（6.74%）死亡，144例患者（13.66%）复发。多变量调整后，年龄与OS、BCSS和DFS呈U形关联，两端风险显著更高，OS、BCSS和DFS的年龄拐点分别为44岁、44岁和41岁。对于OS，与第二四分位数相比，第一四分位数（HR，2.09；95%CI：0.90 - 4.84）、第三四分位数（HR，2.44；95%CI：1.05 - 5.65）和第四四分位数（HR，3.38；95%CI：1.51 - 7.54）的OS较差。BCSS和DFS也发现了类似结果。
结论
本研究证实了诊断时年龄与乳腺癌预后之间存在U形关联。
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