天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (11): 1371-1376.doi: 10.11958/20160229

• 临床研究 • 上一篇    下一篇

35 岁及以下年轻乳腺癌患者的临床资料分析

崔芳 1， 刘红 1△， 陆苏 1， 于辰华 1， 宋佳 2， 方志沂 1   

  1. 1 天津医科大学肿瘤医院乳腺二科， 国家肿瘤临床医学研究中心， 天津市肿瘤防治重点实验室， 乳腺癌防治教育部重点实验室 （邮编 300060）； 2 河北大学附属医院乳腺外科
  • 收稿日期:2016-03-30 修回日期:2016-07-05 出版日期:2016-11-15 发布日期:2016-11-15
  • 通讯作者: △Corresponding Author E-mail: lh713@163.com E-mail:ashley0517@126.com
  • 作者简介:崔芳 （1990）， 女， 硕士在读， 主要从事乳腺癌个体化治疗研究

Analysis on the clinical data of breast cancer in women aged 35 years and younger

CUI Fang1, LIU Hong1△， LU Su1, YU Chenhua1, SONG Jia2， FANG Zhiyi1   

  1. 1 The Second Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Tianjin Key Laboratory of Cancer Prevention and Therapy; Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin 300060, China； 2 Department of Breast Cancer, the Affiliated Cancer Hospital of Hebei University
  • Received:2016-03-30 Revised:2016-07-05 Published:2016-11-15 Online:2016-11-15
  • Contact: △通讯作者 E-mail:lh713@163.com E-mail:ashley0517@126.com

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摘要： 目的 分析 35 岁及以下年轻乳腺癌患者的临床病理特征、 生存情况及影响预后的因素。方法 回顾性 分析天津医科大学肿瘤医院 2008 年 1 月—12 月收治的 105 例治疗规范的年龄≤35 岁年轻乳腺癌患者（年轻组）的 临床及病理资料， 并与同年收治的 103 例治疗规范的 65~70 岁老年乳腺癌患者 （老年组） 进行比较， 并对患者的预后 情况进行随访。结果 年轻组随访期间有 25 例（23.8%）出现局部复发或转移， 17 例（16.2%）死亡； 老年组有 8 例 （7.8%）出现局部复发或转移， 9 例（8.7%）死亡。与老年组相比， 年轻组初诊时原发肿瘤直径大， 组织学分级高， P53 突变率较高（均 P＜0.05）。年轻组 5 年无病生存率低于老年组（76.2% vs. 92.2%， Log-rank χ2=9.799， P=0.002）， 5 年 总生存率与老年组差异无统计学意义 （83.8% vs. 91.3%， Log-rank χ2=2.758， P=0.097）。Cox 多因素分析结果显示， 肿 瘤直径、 是否有腋窝淋巴结转移是影响年轻组乳腺癌患者 5 年无病生存率的独立预后因素， 而 P53 阳性与否和是否 有腋窝淋巴结转移是影响年轻组乳腺癌 5 年总生存率的独立预后因素。结论 年轻乳腺癌患者的生物学行为恶性 程度更高， 预后更差。因此， 对乳腺癌高风险年轻女性需采用针对性的预防筛查策略， 制定个体化治疗方案。

关键词: 乳腺肿瘤, 预后, 临床病理, 年轻患者

Abstract: Objective To analyze the clinical and pathological characteristics and prognosis of breast cancer in women aged 35 years and younger. Methods The clinical data of 105 breast cancer patients (≤35 years) who received comprehensive standardized treatment in our hospital in 2008 were retrospectively analyzed. And the clinical data of 103 breast cancer patients aged 65-70 years treated in our hospital during the same year were chosen as control group. Results During the follow- up period, local recurrence and metastasis were found in 25 patients (23.8% ), and dead in 17 cases (16.2%) in young group. In elderly group, local recurrence or metastasis were found in 8 patients (16.2%) and dead in 9 cases (8.7%). Compared with elderly group, the primary tumor diameter was large, the histological grade was high and the mutation rate of P53 was higher in the younger group (P < 0.05). The 5-year disease-free survival rate was lower in the young group than that of the elderly group (76.2% vs. 92.2% , Log- rank χ2=9.799， P=0.002). There was no significant difference in the 5-year overall survival rate between the two groups (83.8% vs. 91.3%, Log-rank χ2=2.758, P=0.097). Cox multivariate analysis showed that tumor diameter and axillary lymph node metastasis were independent prognostic factors influencing 5- year disease- free survival rate in young group. The positive expression of P53 and axillary lymph node metastasis were independent prognostic factors influencing 5-year overall survival rate in young group. Conclusion Our study indicates that the histological grade of breast cancer is higher and the prognosis is even worse in young patients. Therefore, young women with the high risk of breast cancer need to be targeted for prevention and screening strategies to develop individualized treatment programs.

Key words: breast neoplasms, prognosis, clinical and pathological features, young patient