摘要目的探讨直径≤2cm乳腺癌患者的预后影响因素，为指导个体化治疗及随访提供依据。方法收集2002年1月至2008年12月诊治的475例直径≤2 cm乳腺癌患者，收集完整临床病理资料和随访资料，采用Kaplan－Meier曲线法和Cox风险比例回归模型分析患者的无病生存率、总生存率的影响因素。结果发病年龄≤40岁（ P＝0．000）、腋窝淋巴结转移（ P＝0．000）、组织学分级为3级（P＝0．013）与5年无病生存率呈负相关；发病年龄≤40岁（P＝0．000）、腋窝淋巴结转移（P＝0．000）、组织学分级为3级（P＝0．012）、雌激素受体（ER）阴性（P＝0．035）与5年总生存率呈负相关。多因素分析显示，发病年龄≤40岁（HR＝3．249，95％CI：1．514～6．974，P＝0．002）、腋窝淋巴结转移（ HR＝3．177，95％CI：1．695～5．953，P＝0．000）是直径≤2 cm乳腺癌患者5年无病生存的独立危险因素；发病年龄≤40岁（HR＝5．006，95％CI：2．013～12．449，P＝0．001）、腋窝淋巴结转移（HR＝4．461，95％CI：1．948～10．218，P＝0．000）、ER阴性（HR＝2．612，95％CI：1．092～6．246，P＝0．031）是影响直径≤2 cm乳腺癌患者5年总生存率的独立预后因素。结论发病年龄≤40岁、腋窝淋巴结转移、ER阴性是影响直径≤2 cm乳腺癌复发、转移的危险因素，对于这部分患者应加强综合治疗和随访。

abstractsObjective To study the prognostic parameters in patients with breast cancer of size smaller than or equal to 2 cm which are useful for treatment and follow-up.Methods Four hundred and seventy-five patients with breast cancer of size smaller than or equal to 2 cm diagnosed and treated in Affiliated Union Hospital, Fujian Medical University, China during the period from January, 2002 to December, 2008 were enrolled into the study.The clinical features, pathologic findings and follow-up data were analyzed.Kaplan-Meier curve method and Cox proportional hazard regression model were used to study factors which influenced disease-free survival and overall survival of the patients.Results Onset below 40 years of age (P=0.000), presence of axillary lymph node metastasis (P=0.000) and histologic grade 3 ( P=0.013 ) negatively correlated with 5-year disease-free survival.Onset below 40 years of age ( P =0.000), presence of axillary lymph node metastasis (P=0.000), histologic grade 3 (P =0.012) and negative estrogen receptor status (P=0.035) negatively correlated with 5-year overall survival.Multivariate analysis indicated that onset below 40 years of age ( HR=3.249, 95%CI:1.514-6.974, P=0.002) and presence of axillary lymph node metastasis (HR =3.177, 95% CI: 1.695 -5.953, P =0.000) were independent predictors of 5-year disease-free survival.Onset below 40 years of age ( HR=5.006, 95%CI:2.013-12.449, P=0.001), presence of axillary lymph node metastasis (HR=4.461, 95%CI:1.948-10.218, P=0.000) and negative estrogen receptor status ( HR=2.612, 95% CI:1.092-6.246, P=0.031) were independent predictors of 5-year overall survival.Conclusions Onset below 40 years of age, presence of axillary lymph node metastasis and negative estrogen receptor status are prognostic indicators in patients with breast cancer of size less than or equal to 2 cm.Assessment of these prognostic parameters would be helpful in treatment and follow-up of this group of breast cancer patients.