乳腺癌合并甲状腺癌患者的临床病理特征分析
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摘要
目的:研究乳腺癌合并甲状腺癌患者的临床病理特征。方法:收集80例乳腺癌合并甲状腺癌患者(乳腺癌合并甲状腺癌组)及50例单纯乳腺癌患者(单纯乳腺癌组)的临床资料。将乳腺癌与甲状腺癌诊断时间相隔≤6个月患者纳入同时组(n=24),将乳腺癌与甲状腺癌诊断时间相隔>6个月患者纳入异时组(n=56)。对所有患者进行为期4年的随访,统计患者无病生存(DFS)情况。结果:乳腺癌合并甲状腺癌组雌激素受体(ER)阳性率、孕激素受体(PR)阳性率、人表皮生长因子受体-2(HER-2)阴性率显著高于单纯乳腺癌组(P<0.05)。在随访期间,乳腺癌合并甲状腺癌组复发转移9例,死亡3例;单纯乳腺癌组复发转移3例,死亡1例,两组DFS的生存曲线比较,差异有统计学意义(P<0.05)。在随访期间,同时组复发转移5例,死亡2例;异时组复发转移4例,死亡1例,两组DFS的生存曲线比较,差异有统计学意义(P<0.05)。结论:ER阳性、PR阳性、HER-2阴性的乳腺癌患者具有更高罹患甲状腺癌的概率,乳腺癌合并甲状腺癌可能增加疾病进展、局部复发和远处转移风险。
Objective:To study the clinical and pathological features of breast cancer with thyroid cancer.Methods:The clinical data from 80 patients with breast cancer combined with thyroid cancer and 50 patients with simple breast cancer were collected.Patients were divided into two groups based on the interval between diagnosis of breast cancer and thyroid carcinoma:group A(6 and less than 6 months,n=24)and group B(more than 6 months,n=56).All patients were followed up for 4 years and the disease free survival(DFS)was statistically analyzed.Results:The estrogen receptor(ER)positive rate,progesterone receptor(PR)positive rate and human epidermal growth factor receptor-2(HER-2)negative rate in the breast cancer with thyroid cancer group were significantly higher than those in the simple breast cancer group(P<0.05).There were 9 cases of recurrence and metastases and 3 patients died in the breast cancer with thyroid cancer group,while 3 cases of recurrence and metastases and 1 patient died in the simple breast cancer group during the follow-up period.A significant difference was noted in the DFS curve between the two groups(P<0.05).There were 5 cases of recurrence and metastases and 2 patients died in the group A,while 4 cases of recurrence and metastases and 1 patient died in the group B during the followup period.There was also significant difference in the DFS curve between the two groups(P<0.05).Conclusion:ER positive,PR positive and HER-2 negative patients with breast cancer have higher risk of thyroid cancer.Breast cancer combined with thyroid cancer may increase the risks of disease progression,local recurrence and distal metastasis.
Objective:To study the clinical and pathological features of breast cancer with thyroid cancer.Methods:The clinical data from 80 patients with breast cancer combined with thyroid cancer and 50 patients with simple breast cancer were collected.Patients were divided into two groups based on the interval between diagnosis of breast cancer and thyroid carcinoma:group A(6 and less than 6 months,n=24)and group B(more than 6 months,n=56).All patients were followed up for 4 years and the disease free survival(DFS)was statistically analyzed.Results:The estrogen receptor(ER)positive rate,progesterone receptor(PR)positive rate and human epidermal growth factor receptor-2(HER-2)negative rate in the breast cancer with thyroid cancer group were significantly higher than those in the simple breast cancer group(P<0.05).There were 9 cases of recurrence and metastases and 3 patients died in the breast cancer with thyroid cancer group,while 3 cases of recurrence and metastases and 1 patient died in the simple breast cancer group during the follow-up period.A significant difference was noted in the DFS curve between the two groups(P<0.05).There were 5 cases of recurrence and metastases and 2 patients died in the group A,while 4 cases of recurrence and metastases and 1 patient died in the group B during the followup period.There was also significant difference in the DFS curve between the two groups(P<0.05).Conclusion:ER positive,PR positive and HER-2 negative patients with breast cancer have higher risk of thyroid cancer.Breast cancer combined with thyroid cancer may increase the risks of disease progression,local recurrence and distal metastasis.
引文
[1]左婷婷,陈万青.中国乳腺癌全人群生存率分析研究进展[J].中国肿瘤临床,2016,43(14):639-642.
[2]杨海源,江一舟,邵志敏.精准医学时代的乳腺癌研究[J].中华肿瘤杂志,2016,38(6):401-403.
[3]田文,郗洪庆.甲状腺癌病人生存现状分析[J].中国实用外科杂志,2016,36(5):489-493.
[4]董芬,张彪,单广良.中国甲状腺癌的流行现状和影响因素[J].中国癌症杂志,2016,26(1):47-52.
[5]侯丁丁,凌煜玮,康骅.乳腺癌患者并发第二原发甲状腺癌的诊治现状[J].新医学,2017,48(8):515-518.
[6]中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2011版)[J].中国癌症杂志,2011,21(5):367-417.
[7]中国抗癌协会头颈肿瘤专业委员会.分化型甲状腺癌诊治指南[J].中国实用外科杂志,2011,31(10):908-914.
[8]李双,范红敏,肖菲菲,等.不同分子分型及临床病理特征与乳腺癌术后患者预后的关系[J].临床与实验病理学杂志,2016,32(1):39-44.
[9]王昊天,侯辛未,叶贝贝,等.双侧原发性乳腺癌的临床病理特征及预后因素分析[J].中华肿瘤杂志,2016,38(4):289-293.
[10]郑希希,贾勇圣,史业辉,等.乳腺癌多原发癌的临床病理特征及预后分析[J].中国肿瘤临床,2017,44(5):219-223.
[11]陈青,孟刚,黄雯,等.乳腺癌中ERα、PR的表达与预后关系及其影响阳性率的相关因素[J].临床与实验病理学杂志,2016,32(1):13-18.
[12]杨虹,曾福仁,刘剑仑,等.ER、PR、HER-2、Ki-67与乳腺癌新辅助化疗疗效相关性分析[J].中国现代医学杂志,2016,26(24):54-57.
[13]韩玉萍,王桐桐,王婷,等.ER、PR及其相应拮抗剂与甲状腺癌的相关性研究进展[J].标记免疫分析与临床,2016,23(5):571-574.
[14]苏永辉,姜永冬,谢静静,等.乳腺癌中HER-2基因多态性与蛋白表达的相关性研究[J].中国癌症杂志,2016,26(2):140-144.
[15]郭晨明,吴楠,郭丽英.我国HER-2阳性乳腺癌预后影响因素的Meta分析[J].中国普通外科杂志,2016,25(2):264-270.
[16]贾巍,尹长恒.P53、Her-2和Ki67在甲状腺乳头状癌中的表达及其临床意义[J].中国现代医学杂志,2018,28(5):33-37.
[17]田文,郗洪庆.甲状腺癌病人生存现状分析[J].中国实用外科杂志,2016,36(5):489-493.
[18]郑希希,贾勇圣,史业辉,等.乳腺癌多原发癌的临床病理特征及预后分析[J].中国肿瘤临床,2017,44(5):219-223.
[2]杨海源,江一舟,邵志敏.精准医学时代的乳腺癌研究[J].中华肿瘤杂志,2016,38(6):401-403.
[3]田文,郗洪庆.甲状腺癌病人生存现状分析[J].中国实用外科杂志,2016,36(5):489-493.
[4]董芬,张彪,单广良.中国甲状腺癌的流行现状和影响因素[J].中国癌症杂志,2016,26(1):47-52.
[5]侯丁丁,凌煜玮,康骅.乳腺癌患者并发第二原发甲状腺癌的诊治现状[J].新医学,2017,48(8):515-518.
[6]中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2011版)[J].中国癌症杂志,2011,21(5):367-417.
[7]中国抗癌协会头颈肿瘤专业委员会.分化型甲状腺癌诊治指南[J].中国实用外科杂志,2011,31(10):908-914.
[8]李双,范红敏,肖菲菲,等.不同分子分型及临床病理特征与乳腺癌术后患者预后的关系[J].临床与实验病理学杂志,2016,32(1):39-44.
[9]王昊天,侯辛未,叶贝贝,等.双侧原发性乳腺癌的临床病理特征及预后因素分析[J].中华肿瘤杂志,2016,38(4):289-293.
[10]郑希希,贾勇圣,史业辉,等.乳腺癌多原发癌的临床病理特征及预后分析[J].中国肿瘤临床,2017,44(5):219-223.
[11]陈青,孟刚,黄雯,等.乳腺癌中ERα、PR的表达与预后关系及其影响阳性率的相关因素[J].临床与实验病理学杂志,2016,32(1):13-18.
[12]杨虹,曾福仁,刘剑仑,等.ER、PR、HER-2、Ki-67与乳腺癌新辅助化疗疗效相关性分析[J].中国现代医学杂志,2016,26(24):54-57.
[13]韩玉萍,王桐桐,王婷,等.ER、PR及其相应拮抗剂与甲状腺癌的相关性研究进展[J].标记免疫分析与临床,2016,23(5):571-574.
[14]苏永辉,姜永冬,谢静静,等.乳腺癌中HER-2基因多态性与蛋白表达的相关性研究[J].中国癌症杂志,2016,26(2):140-144.
[15]郭晨明,吴楠,郭丽英.我国HER-2阳性乳腺癌预后影响因素的Meta分析[J].中国普通外科杂志,2016,25(2):264-270.
[16]贾巍,尹长恒.P53、Her-2和Ki67在甲状腺乳头状癌中的表达及其临床意义[J].中国现代医学杂志,2018,28(5):33-37.
[17]田文,郗洪庆.甲状腺癌病人生存现状分析[J].中国实用外科杂志,2016,36(5):489-493.
[18]郑希希,贾勇圣,史业辉,等.乳腺癌多原发癌的临床病理特征及预后分析[J].中国肿瘤临床,2017,44(5):219-223.