Evaluation of autoimmune phenomena in patients with nonalcoholic fatty liver disease on the basis of liver pathology

BACKGROUND Autoimmune phenomena can be used in some patients with nonalcoholic fatty liver disease(NAFLD)in the clinic,but these patients are not autoimmune hepatitis patients.AIM To determine whether autoimmunity is present in patients with NAFLD,this study was performed.METHODS A total of 104 patients with NAFLD diagnosed by liver biopsy at Tianjin Second People’s Hospital between 2019 and 2023 were enrolled.The patients were divided into three groups according to their biopsy results:The NAFL(n=36),nonalcoholic steatohepatitis(n=51),and liver cirrhosis groups(n=17).RESULTS The differences in IgA,an immune marker,among the three groups of patients were statistically significant(P=0.025).In all NAFLD patients,antinuclear antibody and anti-smooth muscle antibody were the most common autoantibodies.The antinuclear antibody detection rate was the highest at 48.1%.The cirrhosis group had the highest autoantibody positivity rate(64.7%).Portal enlargement is also common in NAFLD patients.The rates of positivity for portal lymphoplasmacytic infiltration,small bile duct hyperplasia and interfacial hepatitis were highest in the cirrhosis group;the differences between the cirrhosis group and the other two groups were significant(P<0.05).Hepatocellular rosettes were identified only in the cirrhosis group(11.8%).CONCLUSION Autoimmune phenomena occur in NAFLD patients,especially in patients with NAFLD-related cirrhosis,in whom this phenomenon may be more pronounced.

Requirements for implementation of artificial intelligence in the practice of gastrointestinal pathology

Tremendous advances in artificial intelligence(AI)in medical image analysis have been achieved in recent years.The integration of AI is expected to cause a revolution in various areas of medicine,including gastrointestinal(GI)pathology.Currently,deep learning algorithms have shown promising benefits in areas of diagnostic histopathology,such as tumor identification,classification,prognosis prediction,and biomarker/genetic alteration prediction.While AI cannot substitute pathologists,carefully constructed AI applications may increase workforce productivity and diagnostic accuracy in pathology practice.Regardless of these promising advances,unlike the areas of radiology or cardiology imaging,no histopathology-based AI application has been approved by a regulatory authority or for public reimbursement.Thus,implying that there are still some obstacles to be overcome before AI applications can be safely and effectively implemented in real-life pathology practice.The challenges have been identified at different stages of the development process,such as needs identification,data curation,model development,validation,regulation,modification of daily workflow,and cost-effectiveness balance.The aim of this review is to present challenges in the process of AI development,validation,and regulation that should be overcome for its implementation in real-life GI pathology practice.

Clinical,muscle pathology and molecular genetic analysis of myofibrillar myopathy 3 associated with MYOT gene mutation

Objective To analyze the clinical phenotypic characteristics,muscle pathology,genetic mutations and related proteins of myofibrillar myopathy 3 caused by mutation in MYOT gene,and to conduct a literature review and summary of this disease.Methods A retrospective analysis of the clinical phenotypic characteristics.

Study on the Relationship between Blood Stasis Syndrome and Clinical Pathology in 227 Patients with Primary Glomerular Disease

To investigate the relationship between the severity of Chinese medicine(CM) bloodstasis syndrome(BSS) with clinical features and renal lesion indexes of the primary glomerular disease. Methods:An epidemiological survey was conducted to collect the data of 227 patients diagnosed as chronic primary glomerular diseases,and their severity of BSS were scored three days before renal biopsies were performed.The following clinical indexes were analyzed:age,course of glomerular diseases,24-h urine protein ration(Up...

Associations of preorchiectomy hormone levels to testicular germ cell tumor pathology,clinical stage,and size

Dear Editor,Despite the substantial body of evidence describing the alternations in and impact of hormones after treatment of unilateral testicular germ cell tumors(GCTs),only a few studies have examined hormone levels before radical orchiectomy.1 This letter details our investigation of the relationship between preorchiectomy hormone levels and surgical pathology,clinical stage,and tumor size among patients with GCTs.Differences in GCT presentation were expected based on varying preorchiectomy hormone levels.

What benefit can be obtained from magnetic resonance imaging diagnosis with artificial intelligence in prostate cancer compared with clinical assessments?

The present study aimed to explore the potential of artificial intelligence(AI)methodology based on magnetic resonance(MR)images to aid in the management of prostate cancer(PCa).To this end,we reviewed and summarized the studies comparing the diagnostic and predictive performance for PCa between AI and common clinical assessment methods based on MR images and/or clinical characteristics,thereby investigating whether AI methods are generally superior to common clinical assessment methods for the diagnosis and prediction fields of PCa.First,we found that,in the included studies of the present study,AI methods were generally equal to or better than the clinical assessment methods for the risk assessment of PCa,such as risk stratification of prostate lesions and the prediction of therapeutic outcomes or PCa progression.In particular,for the diagnosis of clinically significant PCa,the AI methods achieved a higher summary receiver operator characteristic curve(SROC-AUC)than that of the clinical assessment methods(0.87 vs.0.82).For the prediction of adverse pathology,the AI methods also achieved a higher SROC-AUC than that of the clinical assessment methods(0.86 vs.0.75).Second,as revealed by the radiomics quality score(RQS),the studies included in the present study presented a relatively high total average RQS of 15.2(11.0–20.0).Further,the scores of the individual RQS elements implied that the AI models in these studies were constructed with relatively perfect and standard radiomics processes,but the exact generalizability and clinical practicality of the AI models should be further validated using higher levels of evidence,such as prospective studies and open-testing datasets.

Clinical manifestations,diagnosis and long-term prognosis of adult autoimmune enteropathy:Experience from Peking Union Medical College Hospital

BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.

Pathological diagnosis and clinical feature analysis of descending duodenal mucosal adenocarcinoma:A case report

BACKGROUND Mucosal adenocarcinoma of the descending duodenum is a very rare gastroin-testinal tumor.Due to its low incidence,it has rarely been the focus of clinical and pathological studies.The clinical manifestations of these tumors are usually nonspecific,and they are easily misdiagnosed or missed.Pathological diagnosis is the gold standard for diagnosis,but due to the small number of cases,the relevant pathological characteristics and diagnostic criteria are not completely clear.The purpose of this study was to deepen the understanding of the diagnosis and treatment of this disease and to provide a clinical guidance.CASE SUMMARY A 61-year-old woman who was hospitalized with recurrent abdominal pain for more than 20 days.The patient developed epigastric pain with no obvious cause more than 20 days prior,mainly left epigastric pain and middle epigastric pain,and presented persistent dull pain without nausea or vomiting,fever or chills.The patient was treated at a local hospital,gastroscopy revealed a new lesion in the circum-intestinal cavity in the descending part of the duodenum,and pathological biopsy revealed mucous adenocarcinoma in the descending part of the duode-num.Currently,for further diagnosis and treatment,the patient is admitted to our hospital for surgical treatment for“malignant tumor of the duodenum”in the outpatient department.CONCLUSION Mucosal adenocarcinoma of the descending duodenum has a high misdiagnosis rate and missed diagnosis rate,clinical manifestations lack specificity,and pathological diagnosis is the main basis for diagnosis.

Focus on laboratory tests related to the pathological types of lupus nephritis to implement renal biopsy as early as possible:clinical and pathological analysis of 217 cases of single center lupus nephritis

Objective:To analyze the clinical and laboratory indices of patients with lupus nephritis(LN)of different pathological types and explore the related factors of LN pathological classification,it is helpful to grasp the timing of renal biopsy.Methods:The clinical manifestations,laboratory parameters and renal pathological types of LN patients in recent 20 years were analyzed retrospectively by SPSS 26.0 software.Results:In this study,the first three pathological types were V,IV,V+IV;latent nephritis was common in type II and V;nephritic syndrome was common in type V;nephrotic syndrome was common in type V+IV;chronic renal insufficiency group was mostly type IV;pathological types were correlated with serum creatinine,C3,albumin and erythrocyte sedimentation rate(r=0.315,P<0.001),and serum creatinine was moderately correlated(r=0.315,P<0.001);AI,CI and SLEDAI scores were significantly different among LN patients of different pathological types.Conclusion:LN is closely related to clinical pathology,clinical manifestations,comprehensive analysis of laboratory indicators and SLEDAI score to make a preliminary prediction of LN pathological type,help to initially assess the severity of pathology,improve the timing of renal biopsy implementation,optimize the timing of treatment.

Pathologic and Clinical Analysis of Carcinosarcoma of Esophagus (20 Cases)

Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide support information for clinical diagnosis. Methods: To review and study the clinical data of 20 patients of esophageal carcinosarcoma. Results: Most of esophageal carcinosarcoma grew like pileus or polypus in esophagus, a few of them were infiltrating. Microscopic examination of the resected specimens indicated that the tumor is composed of sarcomatous element and carcinomatous element (the main element), and the surface of such tumor was covered mostly by carcinoma tissues. The result of biopsy showed that the tumor is squamous cell carcinoma. X-ray examination indicated that there was polypus-like smooth and tidy filling defect in the esophagus of such patient, and its mucous membrane showed “daubing-trace” like characteristics. Conclusion: Carcinosarcoma of esophagus is a tumor of low invasion, which grows mainly in the esophageal lumen. The clinical symptoms of this tumor are different from those of esophagus carcinoma in certain degree. The “daubing-trace” like characteristics is typical of X-ray picture. The results of most endoscopic biopsies demonstrate squamous cell carcinoma or lower differentiation carcinoma, which are difficult for confirmed diagnosis before operation.

Understanding Ehrlichia canis Infections in Dogs of Costa Rica: Hematological Findings and Indicative Clinical Signs

Background: A cross-sectional study combining different serological and molecular techniques for the detection of Ehrlichia canis in dogs was carried out to determine hemopathological findings and suggestive clinical signs associated with acute, subclinical and chronic infections in the dog population of Costa Rica. Objectives: The present study describes and analyzes, in a more representative sampling frame, the clinical and hematological presentation of E. canis infection in dogs of Costa Rica in all its clinical stages. Methods: A descriptive analysis of the clinical signs was performed from a 441-dog sample. Serological and molecular techniques for the detection of Ehrlichia canis in dogs were applied. One and two-way ANOVA were carried out to determine the effect of the infection status on the hematological parameters. Results: A total of 0.7% (3/407) dogs were found with acute (seronegative but PCR positive), 29.7% (121/407) with subclinical (seropositive and PCR negative), and 2.5% (10/407) with chronic (seropositive and PCR positive) E. canis infections. Significant hemopathological findings were determined in dogs with acute (thrombocytosis), subclinical and chronic (anemia, thrombocytopenia, leukopenia) E. canis infections. Conclusions: Future studies must determine if dogs with subclinical E. canis infections eliminated the agent without any medication, or if they continue to be persistently infected, and will develop the chronic disease at some point in their lives.

Preliminary study of a new pathological evolution-based clinical hepatolithiasis classification

AIM:To investigate clinical features,treatment strategies and outcomes of patients with hepatolithiasis(HL)undergoing surgical treatment,using a new clinicalclassification.METHODS:Sixty-eight HL patients were hospitalized and treated surgically from August 2011 to December2012 and they were classified into four HL types according to pathological evolution of the disease.These four HL types included typeⅠprimary type(defined as no previous biliary tract surgery),typeⅡinflammatory type(with previous biliary tract surgery and cholangitis),typeⅢmass-forming type(HL complicated by hepatic mass-forming lesion),and typeⅣterminal type(with secondary biliary cirrhosis and resultant portal hypertension).The perioperative data including general information,imaging data,postoperative complications,and immediate and final stone clearance rate were obtained and analyzed.RESULTS:In all 68 patients,the proportion of HL typeⅠ-Ⅳwas 50%(34/68),36.8%(25/68),10.3%(7/68)and 2.8%(2/68),respectively.Abdominal pain was the main clinical manifestation in typeⅠ(88.2%),fever was predominant in typeⅡ(52.0%),the malignancy rate in typeⅢwas high(71.4%),and portal hypertension and spleen enlargement were common in typeⅣ(2/2,100.0%).Liver resection rate for typesⅠ-Ⅲwas 79.4%,72.0%and 71.4%,respectively.The overall incidence of postoperative complications was23.5%(16/68).There were no perioperative deaths.The average length of hospital stay was 12.7±7.3 d.Immediate and final stone clearance rate was 73.5%(50/68)and 89.7%(61/68),respectively.Fifty-nine of68 patients(86.8%)were followed-up for>1 year after surgery,and 96.6%of these patients(57/59)had a good quality of life according to a criterion recommended for postoperative evaluation of quality of life.CONCLUSION:The pathological evolution-based clinical classification of HL has a role in optimizingtreatment strategy,and patients can benefit from thisclassification when it is used properly.

Clinical and computed tomography features of adult abdominopelvic desmoplastic small round cell tumor

To investigate the clinical and computed tomography(CT)features of desmoplastic small round cell tumor(DSRCT),we retrospectively analyzed the clinical presentations,treatment and outcome,as well as CT manifestations of four cases of DSRCT confirmed by surgery and pathology.The CT manifestations of DSRCT were as follows:(1)multiple soft-tissue masses or diffuse peritoneal thickening in the abdomen and pelvis,with the dominant mass usually located in the pelvic cavity;(2)masses without an apparent organbased primary site;(3)mild to moderate homogeneous or heterogeneous enhancement in solid area on enhanced CT;and(4)secondary manifestations,such as ascites,hepatic metastases,lymphadenopathy,hydronephrosis and hydroureter.The prognosis and overall survival rates were generally poor.Commonly used treatment strategies including aggressive tumor resection,polychemotherapy,and radiotherapy,showed various therapeutic effects.CT of DSRCT shows characteristic features that are helpful in diagnosis.Early discovery and complete resection,coupled with postoperative adjuvant chemotherapy,are important for prognosis of DSRCT.Whole abdominopelvic rather than locoregional radiotherapy is more effective for unresectable DSRCT.

Metastatic tumors to the stomach: Clinical and endoscopicfeatures

AIM: To evaluate the clinical and endoscopic patterns in a large series of patients with metastatic tumors in the stomach. METHODS: A total of 64 patients with gastric meta- stases from solid malignant tumors were retros- pectively examined between 1990 and 2005. The clinicopathological findings were reviewed along with tumor characteristics such as endoscopic pattern, location, size and origin of the primary sites. RESULTS: Common indications for endoscopy were anemia, bleeding and epigastric pain. Metastases presented as solitary (62.5%) or multiple (37.5%) tumors were mainly located in the middle or upper third of stomach. The main primary metastatic tumors were from breast and lung cancer and malignant melanoma. CONCLUSION: As the prognosis of cancer patients has been improving gradually, gastrointestinal (GI) metastases will be encountered more often. Endoscopic examinations should be conducted carefully in patients with malignancies, and endoscopic biopsies and information on the patient’s clinical history are useful for correct diagnosis of gastric metastases.

Clinical observation of pediatric-type follicular lymphomas in adult:Two case reports

BACKGROUND Pediatric-type follicular lymphoma(PTFL)is a unique pathological type in the 4th edition of hematopoiesis and lymphoid tissue tumor classification revised by World Health Organization.It is unique in clinical practice and seldom seen in adult.PTFL mainly occurs in the head and neck lymph nodes.Most of the cases are short of fever,night sweat,weight loss,and other B symptoms which substitute for lymphadenopathy as the main symptom.PTFL can be disposed of surgical resection and it can achieve long-term tumor-free survival,and it has an excellent outcome.CASE SUMMARY Two cases of PTFL were reported and their clinicopathological features,differential diagnosis,therapy and prognosis were discussed.PTFL showed graybrown tough texture in general performance.The histological manifestations of PTFL were similar to that of adult-follicular lymphoma(FL).Under low power microscope,the structure of lymph nodes was destroyed in different degree,the follicles were closely arranged,expanded and irregular,and the mantle zone became thin or disappeared.In addition,the“starry sky phenomenon”could be seen.At high magnification,the follicles were mainly composed of single medium-sized central cells,and some of them mainly consisted of centroblastic cells to characterize scattered chromatin and inconspicuous nucleoli.Immunohistochemical showed the tumor cells expressed CD20,PAX5,CD79a and CD10,BCL6,FOXP-1,which were limited in germinal center;Ki-67 was highly expressed in germinal center.CD21 and CD23 showed nodular and expanded follicular dendritic cells.Immunoglobulin gene rearrangement was positive for IGH and IGK.The two patients underwent surgical resection with no complications.After discharge,the two patients with a close review for 18 mo and 5 mo respectively and showed no evidence of recurrence.CONCLUSION PTFL in adult is generally supposed to be extremely rare.PTFL displayed characteristic morphological,immunophenotypic,and molecular biological changes which are a kind of neoplasm with satisfactory prognosis after surgical excision.

Clinical Pathological Analysis of Synovial Sarcoma

OBJECTIVE To investigate the clinical diagnosis and differential diagno- sis of synovial sarcoma (SS). METHODS A total of 41 paraffin-embedded synovial sarcoma samples were examined by H&E staining, immunohistochemistry staining and the re- verse transcriptase polymerase chain reaction (RT-PCR), in order to provide a scientific bases for diagnosis and differential diagnosis. RESULTS Twelve cases were a biphasic type, 22 cases were a mono- phasic fibrous type, and 7 cases were a poorly differentiated type. Thirty-six cases were both CK (and/or EMA) and Vim positive. Five cases were only Vim positive. A SYT-SSX fusion gene was detected in 18 cases by RT-PCR. CONCLUSION By observation of the histomorphology, immunohisto- chemistry markers and detection of a SYT-SSX fusion gene, we can make a clinical pathological diagnosis of synovial sarcoma.

32例皮肤黑色素瘤临床特点分析

回顾性分析2017年1月至2024年5月我院皮肤科32例皮肤黑色素瘤患者的临床资料。结果示男性发病率为女性的1.46倍;平均发病年龄(69.13±15.95)岁,中位发病年龄为66岁;所有患者均行前哨淋巴结活检,4例淋巴结转移均发生于瘤体>3 cm的患者;SOX10、S-100蛋白、Melan A、HMB45表达阳性率均大于90%;Ki67、Cyclin D1阳性率分别为87.50%、78.13%;Ki67表达水平>5%占比87.50%。

Osteoclastic and pleomorphic giant cell tumors of the pancreas:A review of clinical,endoscopic,and pathologic features

Giant cell tumors of the pancreas come in three varieties-osteoclastic,pleomorphic,and mixed histology.These tumors have distinctive endoscopic,clinical,and cytological features.Giant cell tumors have a controversial histogenesis,with some authors favoring an epithelial origin and others favoring a mesenchymal origin.The true origin of these lesions remains unclear at this time.These are also very rare tumors but proper identification and differentiation from more common pancreatic adenocarcinoma is important.The risk factors of these tumors and the prognosis may be different from those associated with standard pancreatic adenocarcinoma.Recognition of these differences can significantly affect patient care.These lesions have a unique appearance when imaged with endoscopic ultrasound(EUS),and these lesions can be diagnosed via EUS guided Fine Needle Aspiration(FNA).This manuscript will review the endoscopic,clinical,and pathologic features of these tumors.

Primary sclerosing cholangitis associated colitis: Characterization of clinical, histologic features, and their associations with liver transplantation

BACKGROUND Primary sclerosing cholangitis(PSC)associated inflammatory bowel disease(IBD)is a unique form of IBD(PSC-IBD)with distinct clinical and histologic features from ulcerative colitis(UC)and Crohn disease(CD).In patients with PSC and IBD,the severity of the two disease processes may depend on each other.AIM To study the histologic and clinical features of PSC patients with and without IBD.METHODS We assessed specimens from patients with UC(n=28),CD(n=10),PSC and UC(PSC-UC;n=26);PSC and CD(PSC-CD;n=6);and PSC and no IBD(PSC-no IBD;n=4)between years 1999-2013.PSC-IBD patients were matched to IBD patients without PSC by age and colitis duration.Clinical data including age,gender,age at IBD and PSC diagnoses,IBD duration,treatment,follow-up,orthotopic liver transplantation(OLT)were noted.RESULTS PSC-UC patients had more isolated right-sided disease(P=0.03),and less active inflammation in left colon,rectum(P=0.03 and P=0.0006),and overall(P=0.0005)compared to UC.They required less steroids(P=0.01)and fewer colectomies(P=0.03)than UC patients.The PSC-CD patients had more ileitis and less rectal involvement compared to PSC-UC and CD.No PSC-CD patients required OLT compared to 38%of PSC-UC(P=0.1).PSC-IBD(PSC-UC and PSCCD)patients with OLT had severe disease in the left colon and rectum(P=0.04).CONCLUSION PSC-UC represents a distinct form of IBD.The different disease phenotype in PSC-IBD patients with OLT may support liver-gut axis interaction,however warrants clinical attention and further research.

Clinical and pathological features and risk factors for primary breast cancer patients

BACKGROUND Breast cancer is the most common malignancy in women all around the world.According to the latest statistics in 2018,there were more than 2.08 million new breast cancer cases all around the world and more than 620000 deaths;the proportion of breast cancer deaths in women with cancer is 15%.By studying age,clinicopathological characteristics and molecular classification,age at menarche,age at birth,number of births,number of miscarriages,lactation time,surgical history of benign breast lesions,history of gynecological diseases,and other factors,we retrospectively summarized and compared the disease history of patients with primary breast cancer and patients with benign thyroid tumors admitted to our hospital in the past 10 years to explore the clinicopathological characteristics and risk factors for primary breast cancer.AIM To investigate the clinical and pathological features and risk factors for primary breast cancer treated at our center in order to provide a reference for the prevention and treatment of breast cancer in the Zhuhai-Macao region.METHODS Through a retrospective case-control study,149 patients with primary breast cancer diagnosed and treated at Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2013 to March 2020 were included as a case group,and 165 patients with benign breast tumors diagnosed and treated from January 2019 to March 2020 were included as a control group.The data collected included age,age at menarche,age at first birth,number of births,number of miscarriages,lactation time,history of surgery for benign breast lesions,history of familial malignant tumors,history of gynecological diseases,history of thyroid diseases,and the tumor characteristics of the patients in the case group including pathological diagnosis,pathological type,tumor size,lymph node metastasis,distant metastasis,stage,and molecular classification,among others.In the case group,the chi-square test was used to analyze the clinical and pathological features of patients in three age groups(<40,40-59,and≥60 years).A multifactor logistic regression analysis was used to analyze correlations between the two groups.RESULTS Among 149 patients with primary breast cancer,the average age was 48.20±12.06 years,and the proportion of patients at 40-59 years old was the highest,accounting for 61.8%of cases.The molecular type was mainly luminal B type,accounting for 69.2%of cases,and at the time of diagnosis,the tumor stage was mainly stage I/II,accounting for 62.4%of cases.There were no statistically significant differences in the distributions of tumor location,pathological type,tumor size,lymph node metastasis,stage,or molecular classification among the three age groups(<40,40-59,and≥60 years)(P≥0.05).The differences in the distribution of distant metastasis among the three age groups(<40,40-59,and≥60 years)were statistically significant(P<0.01).The differences in lactation time,history of familial malignant tumors,history of gynecological diseases,and history of thyroid diseases between the two groups were not statistically significant(P≥0.05).The differences in age at disease diagnosis,age at menarche,and history of surgery for benign breast lesions were statistically significant(P<0.01).The difference in age at first birth was also statistically significant(P<0.05).CONCLUSION The highest incidence of breast cancer in the Zhuhai-Macao region is present among women aged 40-59 years.There is a larger proportion of stage I/II patients,and the luminal B type is the most common molecular subtype.Distant metastasis occurs mainly in the≥60-year-old group at the first diagnosis;increased age,late age at menarche,and late age at first birth may be risk factors for primary breast cancer,and a history of surgery for benign breast lesions may be a protective factor for primary breast cancer.