تعیین عوامل خطر بروز متاستاز در زنان مبتلا به سرطان پستان

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیار، گروه داخلی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشجوی پزشکی، کمیته‌ی‌ تحقیقات دانشجویی، دانشکده‌ی پزشکی،‌ دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 متخصص پزشکی اجتماعی، معاونت درمان،‌ دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 دانشجوی پزشکی،‌ دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران

چکیده

مقدمه: سرطان پستان یکی از شایع‌‌ترین سرطان‌ها‌ی زنان است و متاستاز آن عامل مهمی در شکست درمان،‌ عوارض و مرگ و میر حاصل از بیماری می‌باشد. این مطالعه به ‌بررسی ارتباط عوامل خطر سرطان پستان ‌با بروز متاستاز پرداخت.روش‌ها: این مطالعه به صورت هم‌گروهی (Cohort) گذشته‌نگر انجام شد. جمعیت مورد مطالعه بیماران مبتلا به سرطان پستان در اصفهان، که در طول ده سال پی‌گیری شدند، بودند. اطلاعات شامل وجود متاستاز به عنوان متغیر وابسته و سن، وضعیت گیرنده‌ها‌ی هورمونی، اندازه‌ی تومور، نوع پاتولوژی، تعداد حاملگی، سن اولین بارداری، وضعیت قاعدگی، سن اولین قاعدگی، سابقه‌ی خانوادگی، روش جراحی، تعداد غدد درگیر و خارج شده حین عمل به عنوان متغیر مستقل از پرونده‌ها‌ی بیماران جمع‌آوری و ‌با آزمون Logestic regression تجزیه و تحلیل گردید.یافته‌ها: ٦٨٥ بیمار مورد مطالعه قرار گرفتند. ٤/٩١ درصد‌ از بیماران بدون متاستاز و ٦/٨ درصد‌ متاستاز داشتند. متاستاز به ریه شایع‌ترین مکان (۷/٤ درصد‌) و پس از آن به ترتیب استخوان (٦/٢ درصد‌)، دیگر مکان‌ها ‌(١/١ درصد‌) و کبد (٣/٠ درصد‌) بودند. از بین متغیرهای مستقل، تعداد غدد لنفاوی درگیر (043/0 > P) و تعداد حاملگی (022/0 > P) با بروز متاستاز اولیه در سرطان پستان ارتباط داشتند.نتیجه‌گیری: این مطالعه نشان داد در بیماران با تعداد بارداری کمتر و غدد لنفاوی درگیر بیشتر، احتمال متاستاز بیشتر است. لذا با شناسایی زودرس این عوامل خطر و انجام تست‌ها‌ی تشخیصی برای یافتن زودتر سرطان متاستاتیک و درمان‌ها‌ی پیش‌گیری کننده ممکن است ‌بتوان مدت بقا را در بیماران افزایش داد.

کلیدواژه‌ها


عنوان مقاله [English]

Risk Factors of Metastasis in Women with Breast Cancer in Isfahan, Iran

نویسندگان [English]

  • Fariborz Mokarian 1
  • Neda Abdeyazdan 2
  • Neda Motamedi 3
  • Parnian Tabesh 2
  • Shirin Mokarian 2
  • Fariba Hashemi 2
  • Maedeh Abbasi 4
1 Associate Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Community Medicine Specialist, Isfahan University of Medical Sciences, Isfahan, Iran
4 Student of Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
چکیده [English]

Background: Breast cancer is one of the most common malignancies in women and its metastasis plays an important role in mortality, treatment failures and complications. The objective of this study was to evaluate the risk factors of metastatic breast cancer.Methods: In a retrospective cohort study, breast cancer patients in Isfahan, Iran were followed up for ten years. The existence of metastasis was considered as the dependent variable while independent variables included age at diagnosis, hormone receptor status, family history, number of lymph nodes dissected in surgery and involved ones, number of pregnancies, age at first pregnancy and menarche, menstrual status, histopathology and tumor size. All data was collected from patients' profiles and analyzed using logistic regression in SPSS16.Findings: A total of 685 patients with breast cancer were studied during 1999-2009. While 91.4% of cases had no metastasis, distant metastasis was found in 8.6% of subjects. Sites of metastasis according to prevalence were lung (4.7%), bone (2.6%), other organs (1.1%), and liver (0.3%). Number of involved lymph nodes (P = 0.043) and number of pregnancies (P = 0.022) had significant relationships with metastasis.Conclusion: We concluded that less pregnancies and more involved lymph nodes indicate a high probability of metastasis occurrence. Therefore, survival improvement might be possible with early diagnosis of breast cancer, using prophylactic treatments, and identifying metastatic cases by diagnostic tests.

کلیدواژه‌ها [English]

  • Breast Neoplasms
  • Neoplasm metastasis
  • Risk Factors
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