化療誘導閉經對激素受體陽性乳腺癌患者預后的影響

麻爽　　朱德淼　　陶百慧　　高迪迪

[關鍵詞] 乳腺癌;化療誘導閉經;預后;激素受體陽性

[中圖分類號] R737.9? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）21-0045-04

Effect of chemotherapy-induced amenorrhea on the prognosis of patients with hormone receptor-positive breast cancer

MA Shuang? ? ZHU Demiao? ?TAO Baihui? ?GAO Didi

Department of Breast Surgery，The First Affiliated Hospital of Jinzhou Medical University，Jinzhou? ?121000，China

[Abstract] Objective To retrospectively analyze the relationship between the occurrence of chemotherapy-induced amenorrhea （CIA） and prognosis in patients with hormone receptor （HR）-positive breast cancer. Methods A total of 194 premenopausal breast cancer patients admitted to the First Affiliated Hospital of Jinzhou Medical University from January 2014 to December 2017 were retrospectively analyzed.All patients enrolled in this study were treated with regular adjuvant chemotherapy after surgery and did not receive ovarian suppression treatment （OST）.Patients were followed up for disease free survival （DFS） and the relationship between the occurrence of CIA and DFS was analyzed. These patients were divided into two groups according to their HR status，and the relationship between the occurrence of CIA and DFS was compared in subgroups. Results At a median follow-up of 51 months，119 patients had CIA，with an incidence of 61.34% （119/194）. There was significant difference in DFS between the group with and without CIA （P=0.014，92.43% vs.82.67%）.In the HR （+） subgroup of 146 patients，the DFS in patients with CIA was significantly higher than those without CIA （P=0.023，95.65% vs. 87.04%）. However，in the HR （-） subgroup of 48 patients，there was no significant difference in DFS between patients with CIA and those without CIA （81.48% vs. 71.43%，P=0.488）. Conclusion The occurrence of chemotherapy-induced amenorrhea has a positive effect on the prognosis of patients，which is more significant in hormone receptor-positive patients.

[Key words] Breast cancer;Chemotherapy-induced amenorrhea;Prognosis;Hormone receptor-positive

乳腺癌是絕經前女性常見的惡性腫瘤[1]。其治療是手術、化療、放療、內分泌及生物靶向治療聯合的綜合性治療[2]。化療誘導閉經（Chemotherapy-induced amenorrhea，CIA）是絕經前乳腺癌患者化療后出現的一種副反應[3]，其發生會影響女性生育能力，產生絕經期癥狀，影響女性生活質量[4]，同時，國外一些研究發現CIA與乳腺癌患者的預后有關[5-7]。本研究對出現和未出現CIA的絕經前乳腺癌患者的無病生存期（Disease free survival，DFS）進行對比，并依照激素受體（Hormone receptor，HR）情況分成亞組，以觀察CIA發生與乳腺癌患者預后的關系。

1 對象與方法

1.1 研究對象