6207例乳腺肿瘤临床病理资料分析

Clinicopathologic Analysis of Patients with Breast Tumors in 6207 Cases

目的探讨1981～2007年27年来乳腺肿瘤发病趋势特点和变化规律,为临床和病理医师提供有价值的参考。方法选自天津医科大学总医院病理科1981～2007年外科手术活检病理档案中的乳腺原发肿瘤6 207例,应用SAS6.0统计软件包对该资料进行统计分析。结果27年来乳腺肿瘤占肿瘤总数百分比呈上升趋势(P=0.005),乳腺恶性肿瘤占恶性肿瘤百分比虽然有所波动,但总体呈上升趋势(P=0.027)。三个年代乳腺良、恶性肿瘤发病平均年龄有增高趋势。三个年代乳腺肿瘤组织学类型也有所变化,乳腺良性肿瘤中,纤维腺瘤和导管内乳头状瘤构成比增加,腺瘤和间叶性肿瘤构成比下降。乳腺恶性肿瘤中,浸润性导管癌仍是主要类型,但导管内癌构成比增加,腺癌和髓样癌有所下降。青年组、中年组和老年组乳腺良、恶性肿瘤组织学类型差异均有统计学意义(P<0.001),良性肿瘤中青年组纤维腺瘤构成比高于中老年组,而导管内乳头状瘤和间叶性肿瘤构成比低于中老年组。恶性肿瘤中青年组恶性叶状肿瘤及浸润性小叶癌高于老年组。结论乳腺肿瘤检出率增加,尤其是乳腺恶性肿瘤检出率增加明显,组织学类型也有所变化,应引起临床和病理医师的注意。

Objective To try to find out the incidence, characteristics and regularity of breast tumors in past 27 years, This may offer valuable information for clinical and pathological doctors. Methods A sta- tistic study was carried on 6 207 cases of breast tumors of the department of pathology in Tianjin Medical University General Hospital from January 1981 to December 2007. The statistic analysis was carried out by SAS 6. 0 statistics software. Results The ratio of breast tumor to total tumor number and the ratio of the breast cancer to malignant tumors have been increasing（P = 0. 005,P = 0. 027） during past 27 years, The average age of breast benign and malignant tamors showed an increased trend. There was a little change in the histological types of the breast tumor among the three eras. The constituent ratios of the fi- broadenoma and the intraductal papilloma increased in the breast benign tumor while the constituent rati- os of the adenoma and the mesenchymoma decreased. Infiltrating duct carcinoma was still amajor type, but the constituent ratio of intraductal carcinoma increased, The constituent ratios of the adenocarcinoma and the medullary carcinoma decreased in the breast malignant tumor. The histological types of breast benign and malignant tumors both had significant difference（P〈0. 001 ） among the youngers, middle-aged and olders. In the breast benign tumor, the constituent ratio of fibroadenoma in the youngers was hiher than that in the middle-aged and olders. But the constituent ratios of the intraductal papilloma and the mesen- chymoma were higher in the middle-aged and olders than in the youngers. In the breast malignant tumor, the constituent ratios of the phyllodes tumor and the infiltrating lobular carcinoma were higher in the youngers than in the olders. Conclusion The detection rate of breast tumors especially that of the breast malignant tumor increased, There was a little change in the histological types among the three eras.