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乳腺癌预后:死亡率指标研究。

Breast Cancer Prognosis: A Study on Mortality Indicators.

出版信息

Chirurgia (Bucur). 2023 Oct;118(5):534-542. doi: 10.21614/chirurgia.2023.v.118.i.5.p.534.

Abstract

The prognosis of breast cancer patients is critical for tailored treatment options. While previous observational studies have identified various prognostic markers, a consensus in their clinical application is lacking. This single-center retrospective study aimed to validate the most frequent risk factors associated with increased mortality in breast cancer patients. Our study spanned an 8-year interval (2014-2020) and included 213 female patients with stage IIA-IIIB breast cancer. Key variables such as age, disease stage, and type of treatment were analyzed in relation to one-year survival as the primary outcome measure. Elevated preoperative levels of tumor markers ACE and CA 15-3, larger tumor size, and advanced lymph nodal invasion were significantly associated with increased mortality. Immunohistochemistry indicated that the presence of Estrogen and Progesterone Receptors (ER and PR) were protective factors, whereas Human Epidermal Growth Factor Receptor 2 (HER2) was a negative prognostic indicator. Among molecular subtypes, Luminal A demonstrated protective effects, whereas HER2-positive and Triple-negative subtypes were identified as risk factors. Conclusion: This study confirms the significant role of tumor size, lymph node stage, and specific molecular markers in predicting breast cancer mortality. These findings contribute to a nuanced understanding of disease prognosis and offer crucial insights for clinicians in managing treatment plans.

摘要

乳腺癌患者的预后对于制定个体化治疗方案至关重要。虽然先前的观察性研究已经确定了各种预后标志物,但在临床应用中缺乏共识。这项单中心回顾性研究旨在验证与乳腺癌患者死亡率增加相关的最常见风险因素。

我们的研究跨越了 8 年的时间(2014-2020 年),纳入了 213 名 IIA-IIIB 期女性乳腺癌患者。关键变量,如年龄、疾病分期和治疗类型,与作为主要结局指标的一年生存率进行了分析。术前肿瘤标志物 ACE 和 CA 15-3 水平升高、肿瘤较大和淋巴结侵袭程度较高与死亡率增加显著相关。免疫组织化学分析表明,雌激素受体(ER)和孕激素受体(PR)的存在是保护因素,而人类表皮生长因子受体 2(HER2)是一个负预后指标。在分子亚型中,Luminal A 型具有保护作用,而 HER2 阳性和三阴性亚型则被认为是危险因素。

结论

本研究证实了肿瘤大小、淋巴结分期和特定分子标志物在预测乳腺癌死亡率方面的重要作用。这些发现有助于深入了解疾病预后,并为临床医生管理治疗方案提供重要见解。

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