pT_(1a)和pT_(1b)乳腺癌130例临床病理特征分析

Analysis of clinical pathological features of 130 patients with pT_(1a) and pT_(1b) breast cancer

目的探讨pT1a和pT1b乳腺癌的临床病理特点。方法回顾性分析我院2008年1月1日至2012年12月31日住院治疗的130例pT1a和pT1b乳腺癌及同期607例pT1c和pT2乳腺癌患者的病例资料,采用卡方检验比较其在年龄分布、月经状况、淋巴结状态、肿瘤组织学分级、雌激素受体(ER)/孕激素受体(PR)表达、人表皮生长因子受体2(HER-2)表达和Ki-67表达指数等临床病理因素上的差异。结果 pT1a和pT1b乳腺癌相比,在各临床病理因素方面均无统计学差异(P>0.05)。pT1a/pT1b相比较于pT1c和pT2乳腺癌,有更多的低组织学分级(G159.2%vs18.6%和12.3%),低Ki-67增殖指数(<14%者,73.8%vs57.7%和55.5%)和阴性淋巴结转移(86.9%vs62.0%和47.4%),均有统计学差异(P<0.01);激素受体阳性表达较多(76.2%vs72.3%和62.2%),但与pT1c组相比无统计学差异(P=0.408),与pT2组相比则有统计学差异(P=0.006);HER2阳性表达较少(21.5%vs22.3%和29.7%),但未达统计学差异(P=0.870和P=0.076);年龄≤35岁者较多(21.5%vs8.8%和13.8%),有统计学差异(P<0.001和P=0.042),但在月经状况上与其他两组无统计学差异(P=0.145和P=0.217)。结论 pT1a和pT1b乳腺癌总体上具有组织学分级较低、Ki67增殖指数较低、激素受体阳性较多和HER2过表达较少的特点。pT1a和pT1b乳腺癌之间的临床病理特征并无明显差别。

Objective To study the clinical and pathologic characteristics of pT1a and pT1b breast carcinoma. Methods From Jan 1st , 2008 to Dec 31st , 2012, 130 patients with pT1a and pT1b breast carcinoma and 607 patients with pT1c and pT2 breast carcinoma were studied retrospectively. Clinical and pathologic factors including age ,.menopausal status,.axillary lymph node metastasis , histologic grade , estrogen receptor （ER） / progesterone receptor （PR） expression, human epidermal growth factor 2 （HER-2） expression and Ki-67 index were analyzed using χ2 test. Results There was no significant difference between pT1a and pT1b breast carcinoma on all factors in this study （P0.05）. pT1a/pT1b breast carcinoma had significant lower histologic grade （G1：59.2% vs 18.6% and 12.3% ）,.lower Ki-67 index. （73.8% vs 57.7% and 55.5% ,those more than 14 percent） and less axillary lymph node metastasis. （86.9% vs 62.0% and 47.4% ）.compared with pT1c and pT2 breast carcinoma （P0.01）..It had significant higher ER / PR expression. （76.2% vs 72.3% and 62.2% ） compared with pT2 breast carcinoma （P=0.006） but not with pT1c breast carcinoma （P=0.408）. HER- 2 positive expression was lower but both with no significant difference （21.5% vs 22.3% and 29.7%）. There was significant more patients aged younger than 35 in pT1a/pT1b breast carcinoma （21.5% vs 8.8% and 13.8% ,.P0.001 and P=0.042）.while no significant difference on menopausal status. Conclusion pT1a and pT1b breast carcinoma likely have such characteristics as lower histologic grade,.lower Ki-67 index,.higher ER / PR expression and lower HER-2 positive expression compared with other larger invasive breast carcinoma..There isn＇t much difference between pT1a and pT1b breast carcinoma.