阿那曲唑治疗绝后乳腺癌继发骨质疏松的预测模型及应用性分析.docVIP

阿那曲唑治疗绝经后乳腺癌继发骨质疏松的预测模型及应用性分析 作者姓名 作者单位 【摘要】目的：搜集绝经后乳腺癌患者服用阿那曲唑后的相关临床指标，构建预测模型以评判继发骨质疏松(osteoporosis, OP)的预测价值，并验证其应用性。 方法：连续性纳入2013年05月至2014年04月期间武汉市中心医院所收治的使用阿那曲唑行内分泌治疗的绝经后乳腺癌患者为研究队列，搜集相关临床资料，对其进行为期36月的随访以确认预后转归。依据随访结果预判继发OP风险的影响性指标，并分析继发OP时间窗以验证该预测模型的应用性。 结果：最终搜集252例符合本次临床试验要求的乳腺癌患者，其中12例患者失访、75例患者继发OP、165例患者于随访期内骨密度正常或相对正常。①Cox回归分析显示，阿那曲唑治疗绝经后乳腺癌患者继发OP的独立影响因素由绝经时间、服用阿那曲唑时间、服用双磷酸盐时间、碱性磷酸酶(alkaline phosphates, ALP)含量组成，其中绝经时间及服用阿那曲唑时间为危险性因素，服用双磷酸盐时间及ALP含量为保护性因素；②服用阿那曲唑时间≥3.017年、服用双磷酸盐时间＜1.878年的患者，继发OP的时间窗更短，其临界值具有显著评判效能。 结论：绝经时间、服用阿那曲唑时间、服用双磷酸盐时间、ALP含量含量是阿那曲唑治疗绝经后乳腺癌患者继发OP的独立影响因素，且服用阿那曲唑时间≥3.017年、服用双磷酸盐时间＜1.878年为衡量本病患者继发OP的时间节点。 【关键词】乳腺癌、骨质疏松、阿那曲唑、芳香化酶抑制剂 Predictive model and application of anastrozole in the treatment of postmenopausal breast cancer secondary to osteoporosis Author’s name Author’s unit 【Abstract】Objective: To collect postmenopausal breast cancer patients taking anastrozole after the relevant clinical indicators, The predictive model was established to evaluate the predictive value of secondary osteoporosis (OP), and then verify its applicability. Methods: Continuity included in the period from May 2013 to April 2014 in Wuhan City Center Hospital treated with anastrozole endocrine therapy for postmenopausal breast cancer patients for the study of the cohort, the clinical data were collected and followed for a follow-up of 36 months to confirm prognosis. According to the follow-up results predictive secondary risk of OP risk indicators, and analyze the secondary OP time window to verify the applicability of the prediction model. Results: The final collection of 252 cases of breast cancer patients in line with the clinical trial requirements, of which 12 patients were lost, 75 patients secondary to OP, 165 patients in the follow-up period of bone mineral density normal or relatively normal. ①Cox regression analysis showed that the independent influencing factors of adjuvant OP in patients with postmenopausal breast cancer were determined by the time