摘要
目的评估三阴性乳腺癌患者引起化疗诱导粒细胞减少症对预后的影响。方法回顾性研究笔者医院接受环磷酰胺联合表柔比星4周期序贯多西他赛4周期（EC×4-T×4）方案化疗117例三阴性乳腺癌患者数据。按照中性粒细胞减少症程度分组，无中性粒细胞减少（中性粒细胞计数≥2．0×10^9／L）为1组、轻度中性粒细胞减少[（1．0～1．9）×10^9／L]为2组、重度中性粒细胞减少（〈0．9×10^9／L）为3组。结果各组临床病理特征比较，差异无统计学意义，比较1组与2组总生存时间差异有统计学意义（P=0．000），1组与3组总生存时间差异有统计学意义（P=0．022）。单因素分析中，病理T分期、N分期、Ki-67、脉管癌栓及中性粒细胞减少症是影响OS的因素（P=0．002、P=0．000、P=0．021、P=0．004、P〈0．05）。在多因素分析中，轻度粒细胞减少症死亡风险比为0．581（95％CI：0．546-0．785，P=0．005），重度粒细胞减少症死亡风险比为0．623（95％CI：0．612～0．798，P=0．005）。结论中性粒细胞减少症提示患者预后较好，可能是化疗有效性的表现。
Objective To assess the association between chemotherapy - moueecl neutropenxa anu lnereasea survival m triple nega- tive breast cancer patients. Methods Data from a retrospective survey for triple negative breast cancer patients in our hospital were re- viewed. 117 patients who had been treated with four cycles of cyelophosphamide plus epirublein, and four cycles of doctaxel（ EC × 4 - T × 4） were studied. The patients were divided into three group aeeording to their degree of neutropenla,group 1 was with absent neutropenia （the count of neutrophils≥ 2.0 × 10^9/L） 、group 2 was with mild neutropinia[ （1.0 - 1.9） × 10^9/L], group 3 was with sever neutropenia （ 〈 0.9 × 10^9/L）. Results The chilinieal and phathologic features in three groups had no statstical difference. In univariate analysis, the T classification, N classification, Ki - 67, vascular tumor emboli and neutropenia significantly effeeted OS （ P = 0. 002, P = 0. 000, P = 0. 021 ,P =0.004 ,P 〈0.05）. In muhivarlate analysis, hazard ratios of death were 0. 581 （95% CI： 0. 546 -0.785 ; P =0. 005） for pa- tients with mild neutropenia, and 0. 623 （95% CI： 0. 612 - 0. 798 ; P = 0. 005 ） for those with severe neutropenia. Conclusion Neutropenia occurring in triple negtive breast cancer patients predicted good prognosis, It may be the biomarker of chemo - therapy efficacy.
出处
《医学研究杂志》
2016年第12期125-129,96,共6页
Journal of Medical Research
