化疗诱导闭经对激素受体阳性乳腺癌患者预后的影响

麻爽　　朱德淼　　陶百慧　　高迪迪

[关键词] 乳腺癌;化疗诱导闭经;预后;激素受体阳性

[中图分类号] R737.9          [文献标识码] B          [文章编号] 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

乳腺癌是絕经前女性常见的恶性肿瘤[1]。其治疗是手术、化疗、放疗、内分泌及生物靶向治疗联合的综合性治疗[2]。化疗诱导闭经（Chemotherapy-induced amenorrhea，CIA）是绝经前乳腺癌患者化疗后出现的一种副反应[3]，其发生会影响女性生育能力，产生绝经期症状，影响女性生活质量[4]，同时，国外一些研究发现CIA与乳腺癌患者的预后有关[5-7]。本研究对出现和未出现CIA的绝经前乳腺癌患者的无病生存期（Disease free survival，DFS）进行对比，并依照激素受体（Hormone receptor，HR）情况分成亚组，以观察CIA发生与乳腺癌患者预后的关系。

1 对象与方法

1.1 研究对象