宝鸡地区绝经后女性乳腺癌特点分析

Analysis of characteristics of breast cancer in postmenopausal female in Baoji area

目的分析宝鸡地区绝经后女性乳腺癌临床、影像、病理特点,为此地区乳腺癌筛查、早诊断、早治疗提供依据。方法选择2016年7月至2018年3月在宝鸡市中心医院影像科行双侧乳腺钼靶X线摄影检查,并经穿刺或手术后病理证实为乳腺癌的女性患者119例,记录患者年龄、腺体类型、绝经情况、乳腺癌激素受体(ER、PR)及Her-2表达情况。比较绝经前、后乳腺癌患者的年龄、乳腺腺体类型分布情况及ER、PR、Her-2表达情况。结果宝鸡地区119例女性乳腺癌中,绝经后患者共67例,平均年龄为(58.24±2.05)岁;绝经前患者共52例,平均年龄为(43.67±1.83)岁;绝经前、后乳腺癌患者的乳腺腺体类型分布情况比较,差异有统计学意义(P=0.000),绝经后女性以脂肪型及散在纤维腺体型腺体为主,绝经前女性以不均匀腺体型及极度致密型腺体为主;绝经前患者的ER、PR阳性表达率均明显高于绝经后患者,差异具有统计学意义(P<0.05);绝经前、后患者的Her-2阳性表达率比较,差异不具有统计学意义(P>0.05)。结论宝鸡地区绝经前、后女性的乳腺癌高发年龄不同,进行乳腺癌筛查时应注意月经情况,绝经后女性以脂肪型及散在纤维腺体型乳腺为主;绝经后女性ER、PR阳性表达比例低于绝经前女性,内分泌治疗效果不如绝经前女性。

Objective To analyze the clinical, imaging and pathological characteristics of breast cancer in postmenopausal female in Baoji area, so as to provide basis for breast cancer screening, early diagnosis and early treatment in that area.Methods From July 2016 to March 2018, 119 female patients with breast cancer accepted mammography of bilateral mammary gland and confirmed by puncture or pathology after operation in the imaging department of Baoji central hospital were selected. The age, gland type, menopause, hormone receptor of breast cancer(ER, PR) and Her-2 expression were recorded, and the age, gland type of breast, expression of ER, PR and Her-2 between premenopausal and postmenopausal patients with breast cancer were compared. Results Among 119 female patients with breast cancer in Baoji area, 67 were postmenopausal, with an average age of(58.24±2.05) years;52 were premenopausal, with an average age of(43.67±1.83)years. The distribution of breast gland types between premenopausal and postmenopausal breast cancer patients had significant difference(P=0.000). The main types of glands in postmenopausal women were adipose glands and scattered fibrous glands, while those in premenopausal women were uneven glands and extremely dense. The positive expression rates of ER and PR in premenopausal patients were higher than those in postmenopausal patients, and the differences were statistically significant(P <0.05);there was no significant difference in Her-2 positive expression rates between premenopausal and postmenopausal patients(P >0.05). Conclusion There are different ages of high incidence of breast cancer in premenopausal and postmenopausal women in Baoji area. Menstruation should be paid attention to in breast cancer screening. The main types of glands in postmenopausal women are adipose glands and scattered fibrous glands;the positive expression rates of ER and PR in postmenopausal women are lower than those in premenopausal women, and the effect of endocrine therapy is not as good as that in premenopausal women.