年龄因素对三阴性乳腺癌患者预后的影响

Prognostic Analysis of Triple Negative Breast Cancer in Young Patients

目的:分析三阴乳腺癌患者低年龄组(<35岁)和高年龄组(≥35岁)临床病理学特征及生存状态,探讨低年龄组预后的独立影响因素。方法:收集2002年1月至2004年12月本院收治的543例可手术三阴性乳腺癌患者的临床资料,回顾性分析低年龄组及高年龄组临床病理学特征及生存情况。采用SPSS 13.0统计软件进行分析,取P<0.05有统计学意义。结果:低年龄组占可手术三阴性乳腺癌患者的7.96%。与高年龄组相比,临床分期Ⅲ期患者占37.21%(P=0.027),肿瘤直径>5cm者占39.53%(P=0.000),组织学分级Ⅲ级的患者占37.21%(P=0.015),腋窝淋巴结阳性者占62.79%(P=0.012),术后进行放疗的患者占53.49%(P=0.010),5年内出现复发转移的患者占44.19%(P=0.000),5年无进展生存率53.49%(P=0.000)及总生存率67.44%(P=0.000)均与高年龄组有统计学差异。单因素和多因素分析结果显示,肿瘤大小、组织学分级及淋巴结状态既是影响三阴乳腺癌患者低年龄组预后的因素也是独立的危险因素。结论:三阴性乳腺癌低年龄组具有肿瘤体积大、恶性程度高、容易转移复发、病期晚、预后差的特点,探索新的更有效的治疗手段将成为今后的研究热点。

Objective： To compare the clinical features and survival for patients with triple negative breast cancer （TN- BC） between different age groups （〈35 years and I〉35 years） and to analyze the prognosis of young patients with TNBC. Methods： The clinical data and survival status of 543 cases of operable TNBC treated in our hospital between January 2002 and December 2004 were collected. SPSS13.0 software was used for statistical analysis. Results： Compared with TNBC in women of 35 or older, the younger patients showed special features. There were 7.96% patients who were below 35 years old, of these 37.21% were of clinical stage Ⅲ （P=0.027）, 39.53 % had tumor size larger than 5 cm （P=0.000）, 37.21% were of histological grade Ⅲ （P=0.015）, 62.79% had positive lymph node status （P=0.012）, 53.49% received postoperative radiotherapy （P=0.009）, and 44.19% had recurrence or metastasis within 5 years （P=0.000）. The 5-year disease-free survival （53.49%,P=0.000） and overall survival （67.44%, P=0.000） were significantly different between the two groups with TNBC. For young patients with TNBC, univariate analysis and multivariate Cox regression analysis showed that tumor size, lymph node status and histological grade were independent prognostic factors. Conclusion： Triple negative breast cancer is generally characterized by large tumor size, high degree of malignancy, high rate of metastasis and recurrence, late onset and poor prognosis. Studies to explore more effective treatment are warranted.