不同年龄段乳腺癌患者的临床病理特点

Clinicopathologic features in different age group patients with breast cancer

目的找出不同年龄段之间乳腺癌患者的临床病理生物学特点,为临床乳腺癌患者个体化治疗提供更多的理论基础。方法回顾性分析总结2001～2008年入住本院并经病理证实且有手术指征的1131例乳腺癌患者的临床病理资料,根据患者年龄分成青年患者、中年患者和老年患者3个组。对3个不同年龄段乳腺癌患者的临床病理生物学指标进行比较分析。统计分析采用卡方检验或秩和检验(Kruskal-WallisH检验)。结果病灶大小和Ki67在3组间存在微弱的统计学意义上的差异(P=0.047,P=0.048)。淋巴结转移、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)、上皮细胞钙黏蛋白(E-cadherin)、多重耐药基因1(MDR1)、DNA拓扑异构酶Ⅱ(TOPO-Ⅱ)以及组织学类型的分布在3组间差异均有统计学意义(P<0.050)。老年患者病灶最大,发生其他组织学类型癌的比例最高,并且ER、PR和E-cadherin的阳性率也最高。青年组发生淋巴结转移的比例最高,HER-2、Ki67、TOPO-Ⅱ以及MDR1的阳性率最高。结论老年乳腺癌的生物学行为最好,青年乳腺癌的生物学行为最差。青年乳腺癌淋巴结转移的风险高。

Objective To search for the differences of the clinicopathologic characteristics in different age groups of patients with breast cancer in order to provide more information for individualized treatment. Methods We retrospectively analyzed the clinical and pathologic features of 1131 breast cancer patients who received operation treatment and were confirmed pathologically after surgery from 2001 to 2008 in our hospital. According to their age, the patients were divided into three groups： a young-age group, a middle-age group and an old-age group. The data of the three groups were compared. Chi-square test or Kruskal-Wallis H test was used. Results There was a slightly statistical difference in the tumor size and ki67 between the three groups（P= 0. 047, P= 0. 048）. There was significant difference in lymph node metastasis, estrogen receptor （ER）, progesterone receptor （PR）, HER-2, E-cadherin, multidrug resistant gene 1 （MDR1）, DNA topoisornerase-II （TOPO-II） and histological types between the three groups （P〈0. 050）. In the old-age group the tumor size was the biggest, and the proportion of other histological type breast cancer, the positive rates of ER, PR and E cadherin were the highest too. In the young-age group the lymph node metastasis rate, the positive expressions of her-2, Ki67, TOPO-II and MDR1 were the highest. Conclusions The biological behavior is better in the old-age breast cancer patients than in the young age patients. The risk of lymph node metastasis of breast cancer in the young age patients is high.