老年与青年乳腺癌临床病理特点与分子分型差异的探讨

The relationship of clinic pathological data and molecular classification between young and elderly patients with breast cancer

目的 通过比较老年和青年乳腺癌患者临床病理特点与分子分型差异,探讨两组不同年龄组乳腺癌治疗及预后的不同.方法 对56例年龄≤35岁的青年乳腺癌患者与93例年龄≥65岁的老年患者的临床病理资料进行回顾性分析,按其免疫组化指标进行分子分型,分析其分布情况,或分析老年组ER＋PR＋与ER＋PR-分型表达.统计学分析采用SPSS21软件.结果 老年组LuminalA型、LuminalB型、Her2过表达型、Basal-like型分别有35例（37.63％）、38例（40.86％）、16例（17.21％）、4例（4.30％）,青年组则分别有9例（16.07％）、29例（51.79％）、13例（23.21％）、5例（8.93％）;与青年组相比,老年组Luminal A型患者较多,差异有统计学意义（P=0.013）.老年组患者肿瘤组织学分级较好（P=0.000）、肿瘤直径较小（P=0.003）、PR阳性者较多（P=0.004）、Her-2阳性者较少（P=0.008）,Ki67低表达者较多（P=0.019）,差异均有统计学意义;老年组中ER＋PR＋组比例高于青年组,差异有统计学意义.两组患者在淋巴结转移、ER阳性率方面无差异.结论 老年组乳腺癌分子分型以Luminal A为主,组织学分级较好,更强调内分泌治疗,预后较好.

Objective To investigate the difference of clinic pathological data and molecular classification between young and old patients with breast cancer Methods We retrospectively analyzed the clinic pathological data of 56 young breast cancer patients （≤35 years） and 93 elderly breast cancer patients （≥65 years） in Obstetrics and Gynecology Hospital of Fudan University from January 2010 to May 2013, and the distribution of classification of breast cancer according to the immunohistochemistry results. The clinical data in the two groups were compared using the SPSS software, P〈 0.05 was considered statistically different. Results In the elder team, 35 （ 37.63 % ） were Luminal A subtype, 38 （ 40.86% ） were Luminal B subtype, 16 （ 17.21% ） were Her-2 positive subtype, 4 （ 4.30 % ） were Basal-like subtype, and 9 （ 16.07 % ） 29 （51.79%）, 13 （23.21%）, 5 （8.93%） subtypes in the young team. Compared with the young patients, Luminal A subtype representing higher proportion in elderly patients （P〈0.05）. Tumor size were smaller （P=0.003）, more PR positive （P=0.004） and less Her-2 expression （P=0.008） and Ki67 （P=0.019） in the elderly patient, while no statistical difference was present on ER expression and lymph node metastasis （P 〉 0.05 ）. Conclusion Luminal A was the major molecular subtype in the elderly group of breast cancer patient. The elderly showed better histological grading and prognosis, and we should focus on endocrine therapy.