双侧原发性乳腺癌2942例荟萃研究.doc

双侧原发性乳腺癌2942例荟萃研究[摘要]目的了解我国BPBC的临床特点,提高对BPBC的诊治水平。方法 通过中国知网检索1994～2008年间国内公开发表的BPBC文献170篇,对2942例BPBC患者的临床特点及预后因素等进行回顾性研究。结果 ①BPBC发病率2.0%,SBPBC占26.3%,MBPBC占73.7%;②主要临床表现是无痛性肿块占100.0%;③Ⅱ期病例占52.3%,浸润性导管癌占49.0%;④随访死亡率41.2%,复发转移率67.6%,5年、10年OS为51.9%及49.7%。结论 BPBC的临床特点为发病率较低、无痛性肿块多位于外上象限、腋淋巴结转移率高、浸润性导管癌及单纯癌多见、术后复发转移率高、及时手术根治预后较好。影响肿瘤预后的主要因素是间隔时间长短、肿瘤大小、临床分期、腋淋巴结转移与否及雌激素受体、癌基因nm23和P53状况。 [关键词] 双侧原发性乳腺癌; 诊断; 预后因素; 文献分析 [中图分类号] R737.9 [文献标识码] A [文章编号] 1673-9701(2010)05-08-03 Bilateral Primary Breast Cancer:An Analysis of 2942 Cases HE Jianjun Department of General Surgery,Affiliated Ningxiang People’s Hospital,Changsha 410600,China [Abstract] ObjectiveTo have understanding of the clinical characteristics of bilateral primary breast cancer(BPBC)in China to improve its diagnosis and treatment. MethodsWe collected 170 internal documents on BPBC published 1994-2008 by CNKI search,and a retrospective study was made of clinical characteristics and prognosis in 2942 cases of BPBC. Results①BPBC incidence rate was 2.0%,in which synchronous bilateral primary breast cancer(SBPBC)accounted for 26.3%,and metachronous bilateral primary breast cancer(MBPBC)73.7%. ②Painless masses as main clinical manifestation in BPBC accounted for 100.0%.③The cases of Stage Ⅱ accounted for 52.3% and infiltrate duct cancer 49.0% in BPBC. ④The follow-up mortality was 41.2%,and the rate of recurrence and metastasis was 67.6%,and 5-year OS and 10-year OS were 51.9% and 49.7%. ConclusionThe clinical features of BPBC show a lower incidence rate,painless masses usually located outside the upper quadrant of mammary glands,a higher axillary lymph node metastasis rate,more common invasive ductal carcinoma and simple cancer,a higher rate of recurrence and metastasis andbetter prognosis after timely surgery. The main factors affecting prognosis are the interval length,tumor size,clinical stage,axillary lymph node metastasis and other factors including estrogen receptor,cancer gene nm23,and P53. [