不同年龄组乳腺癌超声特征以及病理、分子分型对照分析

Comparative analysis of ultrasound features, pathology and molecular typing of breast cancer in different age groups

目的探讨不同年龄组乳腺癌的超声特征以及病理、分子分型差异性。方法回顾性分析2015年1月~2018年12月于浙江大学医学院附属杭州市第一人民医院行手术病理证实的乳腺癌病例789例,按年龄分为青年组(<40岁)、中年组(40~59岁)、老年组(≥60岁),分析乳腺癌病灶的超声、病理及分子分型。结果不同年龄组的非肿块型病变占比青年组(37.96%)>中年组(19.44%)>老年组(11.65%)。不同年龄组的病理类型均以浸润性导管癌(Invasive ductal carcinoma,IDC)为主,其中导管原位癌(Ductal carcinoma in situ,DCIS)占比青年组(21.30%)>中年组(16.39%)>老年组(12.41%)。分子分型中Luminal型为多见,HER2过表达、三阴性型(TNBC)少见,不同年龄组之间比较,差异无统计学意义(P>0.05)。KI-67阳性率占比青年组(73.15%)>中年组(66.28%)>老年组(54.89%),差异有统计学意义(P<0.05)。结论青年乳腺癌非肿块型病变占比、DCIS占比较中老年组高,KI-67阳性率占比较中老年组高,提示预后差。

Objective To investigate the ultrasound features,pathology and molecular typing differences of breast cancer in different age groups.Methods A total of 789 cases of breast cancer confirmed by surgery and pathology in Hangzhou First People's Hospital Affiliated to Zhejiang University Medical College from January 2015 to December 2018 were analyzed retrospectively.They were divided into the adolescent group(<40 years old),the middle-aged group(40-59 years old)and the elderly group(≥60 years old)according to age.The ultrasound features,pathology and molecular typing of breast cancer lesions were analyzed.Results The proportion of non-mass lesions in different age groups was the adolescent group(37.96%)>the middle-aged group(19.44%)>the elderly group(11.65%).Invasive ductal carcinoma(IDC)was the main pathology typing in different age groups,and ductal carcinoma in situ(DCIS)was the adolescent group(21.30%)>the middle-aged group(16.39%)>the elderly group(12.41%).Luminal type was common in molecular typing,while HER2 overexpression and triple negative type(TNBC)were rare,and there was no significant difference among different age groups(P>0.05).The positive rate of KI-67 was the adolescent group(73.15%)>the middle-aged group(66.28%)>the elderly group(54.89%),and the difference was statistically significant(P<0.05).Conclusion The proportion of non-mass lesions and DCIS in the adolescent breast cancer patients is higher than that in the middle-aged and the elderly patients.Meanwhile,the positive rate of KI-67 is higher than that in the middle-aged and the elderly patients,indicating poor prognosis.