阿那曲唑治疗绝经后乳腺癌继发骨质疏松的预测模型及应用性分析作者姓名作者单位【摘要】目的：搜集绝经后乳腺癌患者服用阿那曲唑后的相关临床指标，构建预测模型以评判继发骨质疏松(osteoporosis,OP)的预测价值，并验证其应用性。方法：连续性纳入2013年05月至2014年04月期间武汉市中心医院所收治的使用阿那曲唑行内分泌治疗的绝经后乳腺癌患者为研究队列，搜集相关临床资料，对其进行为期36月的随访以确认预后转归。依据随访结果预判继发OP风险的影响性指标，并分析继发OP时间窗以验证该预测模型的应用性。结果：最终搜集252例符合本次临床试验要求的乳腺癌患者，其中12例患者失访、75例患者继发OP、165例患者于随访期内骨密度正常或相对正常。①Cox回归分析显示，阿那曲唑治疗绝经后乳腺癌患者继发OP的独立影响因素由绝经时间、服用阿那曲唑时间、服用双磷酸盐时间、碱性磷酸酶(alkalinephosphates,ALP)含量组成，其中绝经时间及服用阿那曲唑时间为危险性因素，服用双磷酸盐时间及ALP含量为保护性因素；②服用阿那曲唑时间≥3.017年、服用双磷酸盐时间＜1.878年的患者，继发OP的时间窗更短，其临界值具有显著评判效能。结论：绝经时间、服用阿那曲唑时间、服用双磷酸盐时间、ALP含量含量是阿那曲唑治疗绝经后乳腺癌患者继发OP的独立影响因素，且服用阿那曲唑时间≥3.017年、服用双磷酸盐时间＜1.878年为衡量本病患者继发OP的时间节点。【关键词】乳腺癌、骨质疏松、阿那曲唑、芳香化酶抑制剂PredictivemodelandapplicationofanastrozoleinthetreatmentofpostmenopausalbreastcancersecondarytoosteoporosisAuthor’snameAuthor’sunit【Abstract】Objective:Tocollectpostmenopausalbreastcancerpatientstakinganastrozoleaftertherelevantclinicalindicators,Thepredictivemodelwasestablishedtoevaluatethepredictivevalueofsecondaryosteoporosis(OP),andthenverifyitsapplicability.Methods:ContinuityincludedintheperiodfromMay2013toApril2014inWuhanCityCenterHospitaltreatedwithanastrozoleendocrinetherapyforpostmenopausalbreastcancerpatientsforthestudyofthecohort,theclinicaldatawerecollectedandfollowedforafollow-upof36monthstoconfirmprognosis.Accordingtothefollow-upresultspredictivesecondaryriskofOPriskindicators,andanalyzethesecondaryOPtimewindowtoverifytheapplicabilityofthepredictionmodel.Results:Thefinalcollectionof252casesofbreastcancerpatientsinlinewiththeclinicaltrialrequirements,ofwhich12patientswerelost,75patientssecondarytoOP,165patientsinthefollow-upperiodofbonemineraldensitynormalorrelativelynormal.①CoxregressionanalysisshowedthattheindependentinfluencingfactorsofadjuvantOPinpatientswithpostmenopausalbreastcancerweredeterminedbythetimeofmenopause,thetimeoftakinganastrozole,thetimeofbisphosphonates,thecontentsofalkalinephosphates(ALP)Amongthem,menopausetimeandtakinganastrozoletimeasariskfactor,takingbisphosphonatestimeandALPcontentasprotectivefactors;②takinganastrozoletime≥3.07years,takingbisphosphonatestime<1.878yearsofpatients,secondaryOPtimewindowshorter,thecriticalvalueofasignificantevaluationofefficacy.Conclusion:Menopausetime,takinganastrozoletime,takingbisphosphonatestime,ALPcontentisanastrozoleinthetreatmentofpostmenopausalbreastcancersecondaryOPindependentfactors,andtakinganastrozoletime≥3.07years,takingbisphosphonatestime<1.788yearstomeasurethediseasesecondarytothepatient'stimenode.【KeyWords】Breastcancer,osteoporosis,anastrozole,aromataseinhibitors乳腺癌为当前我国妇女最为常见的恶性肿瘤，约占恶性肿瘤总体发病率的7%-10%。受人口老龄化、饮食结构西化、生育年龄延迟、各项生活习性改变影响，乳腺癌发病率逐年上升[01]；但是得益于超声、钼靶等影像检查技术的进展，乳腺癌早期诊断成为可能，辅以手术、放化...