乳腺癌患者发病年龄和临床病理学参数的相关性研究

Association between age and clinicopathological features of breast cancer patients

目的根据乳腺癌组织病理学分级和HER-2过表达状态,研究早发性乳腺癌的分类方法及与早发性乳腺癌有关的临床病理学参数。方法选取2000年1月之后就诊于长海医院乳腺癌患者2232例,按照每增加5岁为一个发病年龄分层,分为〈30岁、30~34岁、35~39岁、40~44岁、45~49岁和≥50岁6个层次。首先,研究不同发病年龄和组织病理学分级之间的关系,筛选出有意义的年龄层;然后,再将HER-2表达作为筛选因素,进一步剔除和HER-2表达状态无关的年龄层。通过两步筛选,在6个连续的发病年龄分层中选择与组织病理学3级和HER-2过表达有关的发病年龄分界点。最后,根据拟定的早发性乳腺癌的分类方法,综合分析与早发性乳腺癌有关的临床病理学参数。结果当发病年龄〈35岁时,发病年龄与肿瘤组织学分级和HER-2表达均有关,判断35岁可作为早发性乳腺癌的年龄分界点,〈35岁发病可定义为早发性乳腺癌,其特点包括原发肿瘤体积大、淋巴结转移数目多、AJCC分期晚,HER-2阳性以及激素受体阴性表达比例高。结论乳腺癌〈35岁发病定义为早发性乳腺癌具有代表性,它与发病年龄晚的乳腺癌不同,早发性乳腺癌ER/PR阳性率低,HER-2过表达比例高,组织学3级居多。

Objective In this study,firstly the optimal age at diagnosis was identified to differentiate the early-onset breast cancer patients.The associations between the age at diagnosis and clinicopathological features were analyzed.Methods Two thousand two hundred and thirty-two cases with invasive breast cancer in Changhai Hospital of Shanghai were analyzed,which were stratified into 6 groups by age range of 5 years from 30 to 50 years and justified which age was the best resection for association between histologic grade and HER-2.In addition,the association between early-onset breast cancer and other clinicopathological factors were analyzed.Results The association between histologic and HER-2 was only seen in women age35 years.The early-onset breast cancer were more likely HER-2 overexpression,large tumor size,high istologic grade,and JCC stage.Conclusion The early-onset breast cancer in our study was defined as age at diagnosis 35 years old.The early-onset breast cancer in Shanghai was characterized by larger tumor,more lymph node metastasis,later stage,HER-2 overexpression and absent hormonal receptor expression.