绝经前后T_1期乳腺癌患者临床特征的分析

Analysis of clinical characteristics of premenopausal and postmenopausal female patients with breast cancer

目的:分析T1期(肿瘤直径<2cm)原发性乳腺癌女性患者绝经前后在肿瘤大小、病理分类、淋巴结转移率和数目。方法:常规病理检验以及应用免疫组化、HE法分别测定绝经前乳腺癌患者和绝经后乳腺癌患者者的ER、PR。结果:两组患者在肿瘤大小上无明显差异,但绝经前乳腺癌患者浸润导管癌的百分比为 84. 7%,绝经后乳腺癌患者的浸润导管癌百分比为 62. 2%,经χ2 检验,P<0. 01。两组淋巴结转移率分别为 39. 3%和 25. 5%,经χ2 检验,P<0. 01。两组ER和PR阳性伴淋巴结转移的比例经χ2 检验,P<0. 05。结论:绝经前乳腺癌患者和绝经后乳腺癌患者在病理分类、淋巴结转移率及数目、ER、PR阳性伴淋巴结转移上有显著性差异。对于T1原发性乳腺癌患者不论有无淋巴结转移,均应行癌肿切除伴Ⅰ、Ⅱ级淋巴结清扫。

Purpose:To analyze the differences between prem enopausal and postmenopausal female patients with T1 primary breast cancer as to pathological classification, rate of lymphatic metastasis and some relative rec eptors, and to discuss the appropriate mode of operation to T1 breast cancer. Methods:154 patients with T1 primary breast cancer were retrosp ectively divided into premenopausal group and postmenopausal group. The clinical data of the two groups were compared. Results:There were no significant statistical differences in pr imary tumor size, but the incidence rate(62.2%) of invasive ductal cancer in po stmenopausal group was less than that(84.7%) of postmenopausal group(P<0.0 1). Besides, there were significant statistical differences in metastasis of lym ph nodes(P<0.01) and estrogen receptors (ER) and progestogen receptors (PR) with LN(+)(P<0.01). Conclusions:There are significant statistical differences betwe en the two groups in primary tumor size, pathological classification, lymphatic metastasis and the influence of ER/PR positive rate on lymphatic metastasis.Pati ents with T1 primary breast cancers should undergo routine level Ⅰ and Ⅱ axill ary lymph node dissection, particularly T1a and T1b. Surgical axillary lymph nod e dissection remains an essential part of breast cancer management and should no t be abandoned.