青年人乳腺癌176例临床分析

Clinical analysis of 176 cases of young breast cancer

目的探讨青年女性乳腺癌（18～35岁）的临床特点和预后。方法回顾性分析2000～2002年度在本院治疗的青年女性乳腺癌176例，就肿瘤大小、病理类型、TNM分期、淋巴结转移率、雌激素、孕激素受体及C-erbB-2表达等方面与同期就诊的242例中老年女性乳腺癌患者（〉35岁）相比较。结果青年组就诊时间明显晚于中老年组；两组在肿瘤大小及病理类型分布上并无明显差异；组织学分级中，青年组Ⅰ级明显较中老年组少，而Ⅲ级明显多于中老年组，青年组腋窝淋巴结以及内乳淋巴结的转移率均明显高于中老年组，两组比较差异有统计学意义；青年组晚期（Ⅲ、Ⅳ期）病例数比例较中老年组高，青年组ER、PR阳性率低，而C-erbB-2阳性率高，与中老年组相比，差异有统计学意义。结论青年乳腺癌相对于中老年乳腺癌具有临床分期晚，组织学分级高，淋巴结转移率高，激素受体阳性率低，c-erbB-2阳性率高等特点，且复发转移率高，预后差。

Objective To study the clinical features and prognosis of young female breast cancer with 35 years of age or younger. Methods 176 cases of young （18-35 years age）breast cancer were retrospectively analyzed in Hunan Tumor Hospital from 2000 to 2002, and compared with 242 female breast cancer with age older than 35 years in tumor size, histological type, TNM stage, lymph node metastasis, ER and PR and C-erbB-2 expression status. Results There was no significant statistical difference between young group and elder group（P〉0.05） in tumor size and histological type. Histologic grade Ⅲ was much more and grade Ⅰ was less in young patients than elder patients. Both axillary lymph nodes and internal mammary lymph nodes metastasis rate were significantly higher in young patients than that of the elder patients. Early stage （stage I, II ） was significantly less but advanced stage （stage Ⅲ,Ⅳ ） was significantly more in young patients than that in elder patients. ER and PR positive rate were lower in young patients than that of elder patients, but C-erbB-2 positive rate was higher in young patients than that of elder patients （P〈0.05）. Conclusions Compared with elder patients, young patients with breast cancer has the feature of more advanced diseases, high histologic grade, easy lymph node metastasis. Estrogen and progesterone receptor-positive rate is lower, but C-erbB-2 positive rate is higher. Those patients commonly has poor prognosis.