35岁以下女性乳腺癌的临床病理特征及其与预后的相关性

Clinicopathological Features and Their Correlation with Prognosis of Breast Cancer in Women under 35 Years Old

目的探讨35岁以下女性乳腺癌(BC)的临床病理特征及其与预后的相关性。方法回顾性分析四川大学华西医院1 200例女性BC患者的临床资料,比较35岁以下与≥35岁女性乳腺癌患者的临床病理特征,采用Kaplan-Meier法绘制生存曲线,进行影响35岁以下女性BC患者5 a生存率的单因素和多因素分析。结果<35岁组与≥35岁组诊断延迟、肿瘤直径、手术方式、病理类型、淋巴结转移比较,差异有统计学意义(P<0.05);2组双侧乳腺癌、分子分型、组织学分级、ER、Pg R及TNM分期比较,差异无统计学意义(P>0.05);中位随访时间31个月,1 a、3 a、5 a生存率分别为95.31%、88.02%、81.25%,5 a无病生存率为71.88%;35岁以下女性BC患者的5 a生存率与妊娠哺乳期、流产史、肿瘤直径、淋巴结转移、TNM分期、术后化疗显著相关(P<0.05),与年龄、分子分型无关(P>0.05);妊娠哺乳期、流产史、肿瘤直径、淋巴结转移、TNM分期、术后化疗是影响35岁以下女性BC患者预后的独立因素(P<0.05)。结论 35岁以下女性BC具有独特的临床病理特征,妊娠哺乳期、流产史、肿瘤直径、淋巴结转移、TNM分期、术后化疗是影响其预后的独立因素。

Objective To explore the clinicopathological features and their correlation with prognosis of breast cancer in women under 35 years old. Methods The clinical data of 1200 female patients with breast cancer in our hospital were retrospectively analyzed. The clinicopathological features were compared between breast cancer patients35 years old and patients ≥35 years old. The Kaplan-Meier method was used to draw the survival curve and perform univariate analysis and multivariate analysis of 5-year survival rate in patients with breast cancer under 35 years old. Results There was statistically significant difference between the 35-year-old group and the ≥35-year-old group in terms of delayed diagnosis,tumor diameter,surgical method,pathological type and lymph node metastasis（P〉0.05）. There was no significant difference between the two groups in terms of bilateral breast cancer, molecular classification, histological grade, ER, Pg R and TNM stage（P〉0.05）. The median follow-up time was 31 months,and the 1-year,3-year and 5-year survival rates were 95.31%,88.02%and 81.25% respectively,and the 5-year disease-free survival rate was 71.88%. The 5-year survival rate of female patients with breast cancer under 35 years old was significantly related to pregnancy and lactation,miscarriage history, tumor diameter, lymph node metastasis, TNM stage and postoperative chemotherapy（P〈0.05）, but was not related to age and molecular classification（P〉0.05）. The lactation period of pregnancy, miscarriage history,tumor diameter,lymph node metastasis,TNM stage and postoperative chemotherapy were independent factors that affected the prognosis of patients with breast cancer under 35 years old（P〈0.05）. Conclusio Female patients with breast cancer under 35 years old have unique clinicopathological features. The lactati period of pregnancy, miscarriage history, tumor diameter, lymph node metastasis, TNM stage a postoperative chemotherapy are independent factors for the prognosis.