106例青年女性乳腺癌临床病理特点的回顾性分析

目的 回顾性分析青年女性乳腺癌的临床病理特征,探讨其发病特点,为青年女性乳腺癌临床诊治提供经验.方法 整理并分析南方医科大学附属深圳妇幼保健院2007年1月至2012年12月确诊的106例青年(≤35岁)女性乳腺癌(青年组)的临床病理资料及相关免疫组化指标,并与同期诊断的435例年龄＞35岁的中老年女性乳腺癌(中老年组)进行对比分析.计数资料间率的比较采用x2检验.结果 青年组乳腺癌占同期收治乳腺癌的19.6％(106/541),病理类型以浸润性导管癌为主,占86.8％ (92/106).与中老年组比较,其组织学分级(Ⅱ/Ⅲ级)、腋窝淋巴结转移率和HER-2表达水平更高[93.4％ (99/106)比85.3％(371/435),37.7％(40/106)比26.2％(114/435),52.8％(56/106)比40.7％ (177/435),P值均＜0.050,而ER和PR表达水平则更低[57.5％(61/106)比68.5％ (298/435),60.4％ (64/106)比70.3％ (306/435),P值均＜0.050].并且,两组间肿瘤直径、病理类型及P53表达水平的差异均无统计学意义(P＞0.050).结论 青年女性乳腺癌有特殊的临床病理特征,其组织学分级、淋巴结转移率和HER-2表达水平高,而ER、PR表达低,其恶性程度更高,临床处理需注意早期诊断和合理治疗.

Retrospective analysis of clinicopathological characteristics of 106 young women with breast cancer

Objective To retrospectively analyze the clinicopathological characteristics of breast cancer in young women and explore its onset characteristics, so as to provide references for clinical diagnosis and treatment of breast cancer in young female patients. Methods The clinicopathologieal characteristics and the immunohistochemical data of 106 young （ ≤35 years） and 435 elderly （〉35 years） female patients with breast cancer pathologically confirmed in Shenzhen Maternity and Child Healthcare Hospital Affiliated to Southern Medical University from January 2007 to December 2012 were collected and comparatively analyzed. Chi-square test was used for enumeration data. Results Young patients accounted for 19. 6% （ 106/541 ） of all breast cancer patients treated in the hospital during the same period. Invasive ductal carcinoma was the major pathological type （ 86. 8% , 92/106）. Compared with elderly patients, histological grading （ grade Ⅱ / Ⅲ ） [ 93.4% （ 99/ 106） vs 85.3% （371/435） ], rate of axillary node metastases [37.7% （40/106） vs 26. 2% （114/435） ] and positive rate of HER-2 [ 52. 8% （ 56/106 ） vs 40. 7% （ 177/435 ） ] in young patients were higher, but the positive rates of ER [57.5% （61/106） vs 68. 5% （298/435） ] and PR [60. 4% （64/106） vs 70. 3% （306/ 435 ） ] were lower（ P〈0. 050）. There were no significant differences in tumor size, pathological types and P53 level between these two groups （P〉0. 050 ）. Conclusion Breast cancer in young women has its specific elinicopathological characteristics,including higher histological grade, higher rate of axillary nodes metastases and higher positive rate of HER-2, lower positive rates of ER and PR, and higher degree of malignancy, so the surgeon should pay more attention to early diagnosis and clinical treatment of young women with breast cancer.