60例老年乳腺癌患者的病理诊断分析

Pathological diagnosis analysis on 60 cases of breast cancer in elderly patients

目的分析老年乳腺癌患者病理特征,总结诊治经验。方法 2013年1月~2014年12月确诊的60例老年乳腺癌,均进行完整的病理检查,按照收治时年龄大小从低到高进行排序,将前30例患者纳入A组、后30例患者纳入B组,对比病理要素。结果出现症状至就诊时间4 d^36个月;肿瘤长径为0.5~12 cm,平均(2.68±0.41)cm;ER阳性率65.00%、PR阳性率66.67%、HR阳性率70.00%;初潮年龄(16.4±1.40)岁,绝经年龄(51±4)岁;有哺乳史85.00%;乳腺癌家族史5%;浸润性导管癌占68.33%,T0~T2分期占60.00%,N0分期占63.33%,N1分期占28.33%;A组与B组ER、PR、HR阳性率差异无统计学意义(P>0.05);A组与B组T分期、N分期差异无统计学意义(P>0.05);病理Ⅰ期占21.67%,Ⅱ期占48.33%,Ⅲ期占30.00%,组织学分级1级占3.33%,2级占51.67%,3级占6.67%,未知占38.33%;A组与B组病理分期、组织学分级差异无统计学意义(P>0.05)。结论老年人一旦确诊为乳腺癌,其病理特点与年龄关系并不大,患者病理特征相似程度高,为开展病理诊断提供了便利。

Objective To analyze the pathological features of elderly breast cancer patients and to summarize diagnosis and treatment experiences. Methods Sixty cases of elderly breast cancer diagnosed in January 2013 and December2014 were selected and integrated pathological examinations were conducted. Then the patients were ranked ascendingly according to the ages at hospitalization. The younger 30 patients were divided into group A and the elder 30 patients into group B. The pathological features of two groups were compared. Results The time between symptom onset and visiting hospital was 4 d to 36 months. The long diameter of tumor was 0.5-12 cm, with an average of（2.68±0.41）cm.The positive rate of ER was 65.00%, of PR was 66.67%, and of HR was 70.00%. The average age of menarche was（16.4±1.40）y, and the average age of menopause was（51±4）y. 85.00% patients had history of lactation, and 5% had family history of breast cancer. 68.33% were invasive ductal carcinoma, 60.00% were stage T0-T2, 63.33% were NO stage and 28.33% were stage N1. The positive rates of ER, PR, and HR had no significant difference between group A and group B（P〉0.05）. The pathological T stages and N stages had no significant difference between group A and group B（P〉0.05）. As to pathological stages, 21.67% were stage I, 48.33% were stage II, and 30.00% were stage III.And as to histological grades, 3.33% were grade 1, 51.67% were grade 2, 6.67% were grade 3, and 38.33% were unknown. There was no significant difference in pathological stages and histological grades between group A and group B（P〉0.05）. Conclusion Once diagnosed, the pathological features of elderly breast cancer patients have little relation to ages and are highly similar across patients, facilitating the conduction of pathological diagnosis.