中国上海地区乳腺癌的临床病理特征分析

Clinicopathological characteristics of breast cancer from Shanghai region of China:a retrospective analysis

目的研究上海地区乳腺癌患者的临床病理特征。方法统计2008年至2010年上海地区1122例乳腺癌患者的相关临床病理特征,并分析它们之间的联系。结果男性乳腺癌比例为0.89%,低于其他地区。患者发病平均年龄为53岁(中位55岁),其中51～70岁人数最多,占43.85%。就诊时绝大多数为Ⅱ期,其中49.02%患者伴有淋巴结转移。病理分型中浸润性非特殊癌占94.47%,其中浸润性导管癌为90.91%,与国内其他地区相比,特殊类型癌比较少,占3.57%。中位肿瘤直径为3cm,巨大型肿瘤较少。三阴性乳腺癌占18.81%,ER、PR、HER-2的阳性表达率分别为48.6%、59.4%和23.5%。术后病理分期与ER表达呈负相关,与HER-2呈正相关,与PR、Ki-67、E-cadherin、p53、TOPO-Ⅱ、p27、CK5/6均无关。组织学分级可能与E-cadherin有关(P=0.051),与其他表达无关。淋巴结转移与HER-2表达呈正相关;肿瘤大小与ER表达呈负相关,与HER-2表达呈正相关。ER表达与PR呈正相关,与HER-2、Ki-67及p53呈负相关。HER-2与ER、PR、CK5/6表达呈负相关,与Ki-67、TOPO-Ⅱ呈正相关。Ki-67与TOPO-Ⅱ、HER-2表达呈正相关,与ER、p53、p27呈负相关。结论上海地区乳腺癌患者的临床病理特征具有地域性,联合检测ER、PR、HER-2、Ki-67和p53对其诊断并指导治疗具有一定的临床意义。

Objective To study clinicopathological characteristics of breast cancer in Shanghai region. Methods The clini copathological characteristic of 1122 cases of breast cancer patients which diagnosed from 2008 to 2010 in Shanghai region was ana lyzed. Results The onset in male was 0. 89%. The average age was 53 years old（ median age 55 years old）. The onset population of 5170 years was about 43.85%. Most of patients was in stage lI and half of them had lymph nodes metastasis. Non special type of in filtration caner was about 94.47% ,and 90. 91% of them were infiltration duct cancer. Special type of cancer was less than other region in China. The median diameter of tumor was 3era, huge mass were seldom found. Triple negative breast cancer was about 18.81%. The positive expression rate of ER, PR and HER2 was 48.6% ,59.4% and 23.5% , respectively. Pathological staging of triplenega tive breast cancer was correlated negatively with ER and positively with HER2 and was no significantly related to PR, Ki67, Ecadher in. HER2 expression was correlated positively with tumor size. Expression of ER was correlated positively with PR and negatively with HER2, Ki67 and p53. Expression of HER2 was negatively correlated with ER, PR and CK5/6 and positively with Ki67, TOPO H. Expression of Ki67 was correlated positively with TOPOII and HER2 and negatively with ER,p53 and p27. ER,PR,HER2 ,Ki67 and p53 had correlation with clinicopathologic index such as histopathologic type, tumor size and axillary lymphnode metastasis. Con elusion Ciinicopathological characteristics of breast cancer in Shanghai region have some special features, and joint detection of ER, PR, HER2,Ki67 and p53 is very important for diagnosis and treatment in breast cancer.