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种族作为乳腺黏液癌的一个预后因素。

Race as a prognostic factor of breast mucinous carcinoma.

作者信息

Wang Dingyuan, Wang Yang, Gao Songlin, Zheng Rongshou, Wu Guijian, Wang Jianping, Lu Can, Bu Kena, Zhang Chun, Chen Wanqing, Zhang Bailin

机构信息

Department of Breast Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.

Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR.

出版信息

J Cancer Res Clin Oncol. 2024 Dec 27;151(1):25. doi: 10.1007/s00432-024-06035-3.

Abstract

PURPOSE

The rarity of breast mucinous carcinoma (BMC) makes it challenging to study the prognosis of this disease across diverse racial populations. This study aimed to leverage epidemiological data on immigrant populations to elucidate the prognostic differences in BMC patients from various racial/ethnic backgrounds. The goal was to help formulate more personalized clinical practice guidelines for the management of this rare malignancy.

METHODS

The study included 208 BMC patients from China and 10,322 BMC patients from the SEER database. Clinicopathological data, treatment information, and survival outcomes were compared across different racial/ethnic groups using statistical analyses.

RESULTS

Asian American BMC patients were younger at diagnosis and had more favorable tumor grade and stage compared to other racial groups. After adjusting for clinicopathological factors and treatments, Asian American BMC patients exhibited significantly better overall survival (OS) than black (HR = 1.53, 95% CI: 1.05-2.22, P = 0.027) and white patients (HR = 1.41, 95% CI: 1.03-1.94, P < 0.001). Specifically, non-Chinese American patients had a worse OS compared to Chinese patients (adjusted HR = 2.59, 95% CI: 1.15-5.83, P = 0.022). Chemotherapy significantly improved OS only in black BMC patients (adjusted HR = 0.52, 95% CI: 0.27-0.98, p = 0.045), but not in other racial/ethnic groups.

CONCLUSION

Race is an independent prognostic factor for BMC. Compared with Chinese patients, black and white American patients have a worse prognosis in terms of OS. Treatment guidelines for BMC patients should be formulated with considerations of race factors. For patients with BMC originating from China, a more conservative treatment approach may be warranted.

摘要

目的

乳腺黏液癌(BMC)较为罕见,这使得在不同种族人群中研究该疾病的预后具有挑战性。本研究旨在利用移民人群的流行病学数据,阐明不同种族/族裔背景的BMC患者的预后差异。目标是帮助制定更具个性化的临床实践指南,以管理这种罕见的恶性肿瘤。

方法

该研究纳入了来自中国的208例BMC患者和来自监测、流行病学和最终结果(SEER)数据库的10322例BMC患者。使用统计分析比较了不同种族/族裔群体的临床病理数据、治疗信息和生存结果。

结果

与其他种族群体相比,亚裔美国BMC患者诊断时年龄更小,肿瘤分级和分期更有利。在调整临床病理因素和治疗后,亚裔美国BMC患者的总生存期(OS)明显优于黑人患者(风险比[HR]=1.53,95%置信区间[CI]:1.05-2.22,P=0.027)和白人患者(HR=1.41,95%CI:1.03-1.94,P<0.001)。具体而言,非华裔美国患者的OS比中国患者更差(调整后HR=2.59,95%CI:1.15-5.83,P=0.022)。化疗仅在黑人BMC患者中显著改善了OS(调整后HR=0.52,95%CI:0.27-0.98,P=0.045),但在其他种族/族裔群体中未改善。

结论

种族是BMC的独立预后因素。与中国患者相比,美国黑人和白人患者在OS方面预后更差。BMC患者的治疗指南应考虑种族因素来制定。对于来自中国的BMC患者,可能需要更保守的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d34/11680603/b73963937c83/432_2024_6035_Fig1_HTML.jpg

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