上海部分地区30年女性乳腺癌发生的临床病理学差异比较

Comparison of clinicopathological difference between incidences of female breast cancer during the latest 30 years in partial area of Shanghai

目的分析上海市部分地区1978～2007年女性乳腺癌发病情况与临床病理特点的变化趋势,为探索乳腺癌防治措施提供理论基础。方法收集1978年～2007年间长海医院病理科诊断的原发性女性乳腺癌病例共计2548例,以每5年为一个时期对乳腺癌的发病情况和临床病理进行回顾性分析和比较。结果 30年来,该地区乳腺癌病例数增长了511%,乳腺癌占病理检验总量的比例、乳腺肿瘤中恶性肿瘤所占比例均上升。乳腺癌的发病年龄逐期上升,最后1个时期发病平均年龄达53.55岁,与前5个时期相比差异有显著性。浸润性非特殊癌的比例从第1个时期的73.33%上升到第5个时期的84.64%,而最后一个时期又下降到79.28%,非浸润性癌及早期浸润性癌的比例上升。小体积肿瘤和淋巴结转移阴性病例比例持续上升。结论 30年来,该地区乳腺癌发病率呈快速上升趋势,发病年龄呈现老龄化。乳腺癌早期检出率上升,肿瘤恶性比例及浸润性非特殊癌比例也呈现上升趋势。

Purpose To clarify whether or not marked changes in the social environment during the past 30 years in Shanghai have altered the epidemiology and clinicopathologic characteristics of female primary breast cancer.Methods 2 548 cases of female primary breast cancers diagnosed in the Changhai Hospital were retrieved.Comparison of clinicopathologic characteristics of breast cancer in each period（5 years as a period） were conducted.Results The number of breast cancers diagnosed increased by 511% during the past 30 years,the proportion of breast cancer in the total amount of surgically pathologic cases and the malignant proportion of breast tumor were also increased.The age at onset of the last period showed significantly different from the previous 5 periods.The proportion of nonspecific invasive breast carcinoma increased from 73.33% in 1st period to 84.64% in 5th period,but decreased to 79.28% in 6th period,and non-invasive and micro-invasive carcinoma increased year by year.More and more carcinoma with small size and lymph node-negative cases appeared.Conclusions In the past 30 years,the incidence of breast cancer in this area reveals marked increase,and the age at onset becomes older though the detection rate of early stage carcinoma has increased.The trend of the malignant proportion of breast tumor and the proportion of nonspecific invasive breast carcinoma are also increasing.