肥胖与年轻乳腺癌患者临床病理特征的相关性研究

目的:探讨年轻乳腺癌患者的临床病理特点，进一步分析肥胖与其临床病理特征的关系。方法:回顾性分析甘肃省肿瘤医院放疗科2013年1月1日至2017年12月31日收治的108例均经术后病理证实的浸润性乳腺癌患者的临床资料(年龄均≤35岁)，根据中国成年人肥胖划分标准，以体重指数≥28 kg／m2为分界点将患者分为肥胖组和非肥胖组，统计分析两组在临床病理特征方面的差异。结果:相较于非肥胖患者，肥胖患者原发肿瘤更大（P=0.000），肥胖患者中临床分期III期比例以及淋巴结阳性率更高（P值分别为0.003和0.003），肥胖患者Ki-67表达率更高，起病至首诊时间更长（P值分别为0.000和0.020），肥胖患者在分子分型及脉管癌栓方面与非肥胖患者相比均无统计学差异（P值分别为0.100和0.828）。结论:年轻乳腺癌的临床病理特征具有自身特点，相较于非肥胖患者，肥胖患者的病理特征较差。因此，在早期乳腺癌的精准医疗中，除了依据临床病理学特征之外，体重指数也应该在预后风险评估和制定个体化治疗策略中予以重视。

Study on the relationship between obesity and clinical pathological features of young breast cancer patients

Objective:To study the clinicopathologic features of young breast cancer patients and analyze the relationship between obesity and their clinicopathological features.Methods:The clinical dates of 108 breast cancer patients (≤35 years old) treated in department of radiotherapy of the Gansu Provincial Cancer Hospital from January 2013 to December 2017 were retrospectively analyzed.These patients were diagnosed as invasive cancer.According to"guidelines for prevention and control of overweight and obesity in Chinese adults",the patients were divided into obese and non-obese groups.Then the clinicopathological features between the two groups were analyzed.Results:There were significantly statistically differences in the two groups such as the tumor size,clinical stages,lymph node metastasis,the proportion of Ki-67 and the time from the discovery of the lump to treatment,however,the molecular typingand rate ofvessel carcinoma embolus were no statistically differences.Conclusion:Breast cancer in young women have unique characteristics in biological behaviors.The tumor pathologic features of obese patients are poor.Therefore,clinicians need to carry out prognostic risk assessment and individualized treatment strategies based on obesity factor in addition toclinicopathologic indicators.