不同年龄段乳腺癌患者的临床病理特点

doi:10.3877/cma.j.issn.1674-0807.2010.05.008

目的

找出不同年龄段之间乳腺癌患者的临床病理生物学特点,为临床乳腺癌患者个体化治疗提供更多的理论基础。

方法

回顾性分析总结2001～2008年入住本院并经病理证实且有手术指征的1131例乳腺癌患者的临床病理资料,根据患者年龄分成青年患者、中年患者和老年患者3个组。对3个不同年龄段乳腺癌患者的临床病理生物学指标进行比较分析。统计分析采用卡方检验或秩和检验(Kruskal-Wallis H 检验)。

结果

病灶大小和Ki67在3组间存在微弱的统计学意义上的差异(P=0.047,P=0.048)。淋巴结转移、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)、上皮细胞钙黏蛋白(E-cadherin)、多重耐药基因1(MDR1)、DNA 拓扑异构酶Ⅱ(TOPO-Ⅱ)以及组织学类型的分布在3组间差异均有统计学意义(P＜0.050)。老年患者病灶最大,发生其他组织学类型癌的比例最高,并且ER、PR 和E-cadherin的阳性率也最高。青年组发生淋巴结转移的比例最高,HER-2、Ki67、TOPO-Ⅱ以及MDR1的阳性率最高。

结论

老年乳腺癌的生物学行为最好,青年乳腺癌的生物学行为最差。青年乳腺癌淋巴结转移的风险高。

关键词: 乳腺肿瘤, 年龄, 临床病理特点

Objective

To search for the differences of the clinicopathologic characteristics in different age groups of patients with breast cancer in order to provide more information for individualized treatment.

Methods

We retrospectively analyzed the clinical and pathologic features of 1131 breast cancer patients who received operation treatment and were confirmed pathologically after surgery from 2001 to 2008 in our hospital.According to their age,the patients were divided into three groups:a youngage group,a middle-age group and an old-age group.The data of the three groups were compared.Chi-square test or Kruskal-Wallis H test was used.

Results

There was a slightly statistical difference in the tumor size and ki67 between the three groups(P=0.047,P=0.048).There was significant difference in lymph node metastasis,estrogen receptor(ER),progesterone receptor(PR),HER-2,E-cadherin,multidrug resistant gene 1(MDR1),DNA topoisomerase-II(TOPO-Ⅱ)and histological types between the three groups(P＜0.050).In the old-age group the tumor size was the biggest,and the proportion of other histological type breast cancer,the positive rates of ER,PR and E-cadherin were the highest too.In the young-age group the lymph node metastasis rate,the positive expressions of her-2,Ki67,TOPO-Ⅱand MDR1 were the highest.

Conclusions

The biological behavior is better in the old-age breast cancer patients than in the young-age patients.The risk of lymph node metastasis of breast cancer in the young age patients is high.

Key words: Breast neoplasms, Age, Clinicopathological features

表1 1131例患者的临床病理资料和统计结果

病理指标	青年患者(108例)	中年患者(743例)	老年患者(280例)	统计量	P值
病灶大小				6.132	0.047^a
T1(≤2 cm)	56	351	115
T2(2 cm＜T＜5 cm)	42	328	128
T3(≥5 cm)	10	64	37
淋巴结状况				6.81	0.033^a
转移	44	272	82
无转移	62	466	197
不明	2	5	1
TNM分期				0.368	0.832^a
Ⅰ	39	270	105
Ⅱ	50	370	141
Ⅲ	15	92	30
不明	4	11	4
ER				7.534	0.023^a
-	55	283	95
+	53	422	172
不明	0	38	13
PR				9.16	0.010^a
-	63	366	120
+	38	338	146
不明	7	39	14
HER-2				17.384	0.000^a
-～+	59	522	208
++	12	67	21
+++	28	110	30
不明	9	44	21
Ki67				6.081	0.048^a
-	22	177	76
+	25	147	40
不明	61	419	164
E-cadherin				7.61	0.022^a
-	41	234	70
+	23	249	90
不明	44	260	120
GST-π				0.568	0.753^a
-	35	235	100
+	30	244	98
不明	43	264	82
MDR1				7.50	0.024^a
-	56	409	165
+	23	87	30
不明	29	247	85
TOPO-Ⅱ				6.559	0.038^a
-	30	301	130
+	32	176	66
不明	46	266	84
组织学类型				16.273	0.003^b
导管癌	91	670	232
小叶癌	5	28	20
其他类型癌	7	27	24
不明	5	18	4

表1 1131例患者的临床病理资料和统计结果

病理指标	青年患者(108例)	中年患者(743例)	老年患者(280例)	统计量	P值
病灶大小				6.132	0.047^a
T1(≤2 cm)	56	351	115
T2(2 cm＜T＜5 cm)	42	328	128
T3(≥5 cm)	10	64	37
淋巴结状况				6.81	0.033^a
转移	44	272	82
无转移	62	466	197
不明	2	5	1
TNM分期				0.368	0.832^a
Ⅰ	39	270	105
Ⅱ	50	370	141
Ⅲ	15	92	30
不明	4	11	4
ER				7.534	0.023^a
-	55	283	95
+	53	422	172
不明	0	38	13
PR				9.16	0.010^a
-	63	366	120
+	38	338	146
不明	7	39	14
HER-2				17.384	0.000^a
-～+	59	522	208
++	12	67	21
+++	28	110	30
不明	9	44	21
Ki67				6.081	0.048^a
-	22	177	76
+	25	147	40
不明	61	419	164
E-cadherin				7.61	0.022^a
-	41	234	70
+	23	249	90
不明	44	260	120
GST-π				0.568	0.753^a
-	35	235	100
+	30	244	98
不明	43	264	82
MDR1				7.50	0.024^a
-	56	409	165
+	23	87	30
不明	29	247	85
TOPO-Ⅱ				6.559	0.038^a
-	30	301	130
+	32	176	66
不明	46	266	84
组织学类型				16.273	0.003^b
导管癌	91	670	232
小叶癌	5	28	20
其他类型癌	7	27	24
不明	5	18	4

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Clinicopathologic features in different age group patients with breast cancer

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Clinicopathologic features in different age group patients with breast cancer