老年乳腺癌患者的临床病理特点及其辅助治疗模式的研究

Study on the Clinical and Pathological Characteristics and Treatment Patterns of Elderly Patients with Breast Cancer

目的:探讨老年乳腺癌患者的临床病理特点及其辅助治疗模式,为老年乳腺癌患者的临床治疗提供参考。方法:选取2008年1月-2012年1月期间我院收治的50例老年乳腺癌患者作为研究对象,同时选取同期收治的50例中青年乳腺癌患者,比较两组患者的临床病理特征,并采用新辅助内分泌疗法治疗本组50例老年乳腺癌患者,治疗4个月后观察治疗效果。结果:老年乳腺癌患者的病灶>5cm比例以及ER和PR阳性率均明显高于中青年患者,两组患者数据比较差异有统计学意义(P<0.05);老年乳腺癌患者的淋巴结转移率、Ki67阳性率以及HER-2阳性率均低于中青年患者,两组患者数据比较差异均有统计学意义(P<0.05);本组50例老年乳腺癌患者治疗总有疗效为82.0%,ER、PR均为阳性患者的治疗有效率为90.0%,明显高于ER和PR非双阳性患者(76.9%,57.1%),数据比较差异均有统计学意义(P<0.05);TNM I期患者的治疗有效率为93.8%,明显高于TNM II期(76.9%)或TNM III期患者(20.0%),数据比较差异均有统计学意义(P<0.05)。患者在治疗期间均未出现严重不良反应。结论:老年乳腺癌患者的生物学行为较好,病灶大、淋巴转移率低以及ER和PR阳性率高;新辅助内分泌治疗老年乳腺癌患者,尤其对ER、PR均为阳性以及TNM分期低的患者临床效果安全有效,不良反应发生率低,值得临床推广应用。

Objective： To investigate the clinical and pathological characteristics and treatment patterns of elderly patients with breast cancer, and to provide the reference for the clinical treatment of elderly patients with breast cancer. Method： 50 cases of elderly patients with breast cancer treated in our hospital from January 2008 to January 2012 were selected as the research object, and received trearnent of neoadjuvant endocrine therapy; 50 cases of young patients with breast cancer were selected at the same time. The clinical and pathological characteristics of two groups were compared and the therapeutic effect was observed after 4 months of treatment; Result： The proportion of focus〉 5cm, the positive rates of ER and PR in elderly patients were higher than those in young patients, which had statistical significance （P〈0.05）;The rates of lymph node metastasis, the positive rates of Ki67 and HER-2 in elderly patients with breast cancer were lower than those in young patients, the data showed statistical significance （P〈0.05）;Among 50 cases of elderly patients with breast cancer, the total efficacy was 82%, the effective rate in patients of ER and PR positive was 90%,significantly higher than those in non double positive patients （76.9%, 57.1%）, the data showed significant differences （P〈0.05）; The effective rate of TNM I patients was 93.8%, significantly higher than that in TNM II period （76.9%） or TNM HI patients （20%）, the data showed no significant differences 0a〈0.05）.There was no serious adverse reactions during the treatment. Conclusion： The elderly patients with breast cancer have better biological behavior, large focus, low metastasis rate of lymph, high positive rate of ER and PR. Neoadjuvant endocrine therapy applied in the treatment of breast cancer in elderly patients, especially in patients of ER and PR positive and in patients with low TNM stage, presents safe and effective therapeutic effect, low incidence of adverse reactions, thus is worthy of clinical application.