青年与中老年女性乳腺癌患者临床病理特点、分子分型及预后的对比分析

Comparison on Clinicopathologic Characteristics, Molecular Phenotypes and Prognosis of Breast Cancer Between Young and Elderly Female Patients

目的探讨青年与中老年女性乳腺癌患者的临床病理、分子分型及预后情况。方法收集我院138例女性乳腺癌患者,将其中66例(年龄≤35岁)和72例(年龄>35岁)的患者分别纳入青年组和中老年组。回顾性分析两组患者的临床分期、肿瘤直径、病理分级、淋巴结转移及分子分型的特点及预后情况。结果两组患者在肿瘤直径、临床分期、病理分级、淋巴转移方面分布不同,与中老年组相比,青年组肿瘤直径>2 cm者所占比例高,临床分期晚,病理分级高,容易有淋巴结转移,差异均有统计学意义(P<0.05或P<0.01)。分子分型总体分布不同,青年组以三阴性型居多(34.8%),中老年组以Luminal A型居多(36.1%),差异有统计学意义(P<0.01)。青年组与中老年组乳腺癌患者的3年、5年累积生存率分别为87.9%、62.1%及95.8%、76.4%,组间差异无统计学意义(P>0.05)。结论相比中老年乳腺癌,青年女性乳腺癌更具有侵袭性,易发生淋巴结转移,且在临床分期、病理分级及分子分型方面存在明显的差异,因此在临床治疗中,应充分考虑青年乳腺癌的生物学特性,给予个体化的治疗。

Objective To compare the clinicopathologic characteristics, molecular phenotypes and prognosis of breast cancer between young and elderly female patients. Methods A total of 138 female patients with breast cancer were divided into young group(66 patients aged ≤35 years) and elderly group(72 patients aged > 35 years). The clinical stage, tumor diameter, pathological grade, lymph node metastasis, molecular phenotypes and prognosis were analyzed retrospectively. Results The distributions of tumor diameter, clinical stage,pathological grade and lymph node metastasis were different between the two groups. Compared with the elderly group, the proportion of tumor diameter > 2 cm in the young group was higher, the clinical stage was later, the pathological grade was higher and lymph node metastasis was easier, the differences were statistically significant(P <0.05 or P <0.01). The overall distribution of molecular phenotypes was significantly different between two groups(P <0.01). The triple-negative breast cancer was mostly found in young group(34.8%) and luminal A breast cancer in elderly group(36.1%). In the two groups, the 3-year and 5-year cumulative survival rates were 87.9% vs. 95.8%and 62.1% vs. 76.4%, respectively, with no significant difference between the two groups(P >0.05). Conclusions Breast cancer in young female patients is more invasive and easier to lymph nodes metastasize than that in elderly patients. There are significant differences in clinical stages, pathological grade and molecular phenotypes between young and elderly breast cancer patients. Therefore, the biological characteristics of young breast cancer should be fully considered and individualized treatment should be given in clinical treatment.