青年和老年乳腺癌病理特征及预后差异的分析

目的:比较分析青年和老年乳腺癌患者的病理特征与预后的差异。方法:对我科自2011年6月至2012年12月收治42例青年乳腺癌（≤35岁，青年组）和63例老年乳腺癌（≥60岁，老年组）女性患者的临床资料进行整理，将两个年龄段的一般临床资料、病理特点、治疗方式和随访等情况进行比较分析。采用SPSS 24软件进行数据分析。结果:两组在肿瘤发生位置上、手术方式、辅助化疗、内分泌治疗和基因靶向治疗的比较上两组无统计学差异（P>0.05）,而在病程、肿瘤大小、组织病理分级和分期、淋巴结转移情况上比较存在差异性（P<0.05）。青年组中新辅助化疗、乳房重建和辅助放疗多于老年组（P<0.05）。与青年组比较，老年组中PR阳性高表达而HER-2和Ki-67低表达（P<0.05），两组分子分型与ER阳性表达的比较无统计学意义（P>0.05）。随访3年和5年两组的总生率均无统计学意义（P>0.05）,但青年组中复发转移多于老年组（P<0.05）。结论:青年乳腺癌患者具有组织病理学分级和分期晚、恶性程度高、侵袭性强、复发转移率高，预后差的特点。

Comparative study of pathological characteristics and prognosis of breast cancer between young and elderly patients

Objective:To investigate the difference of pathological characteristics and prognosis between young and elderly patients with breast cancer.Methods:We retrospectively analyzed the clinical pathological data，treatment method and follow-up of 42 young breast cancer patients (≤35 years)and 63 elderly breast cancer patients(≥60 years) in Taihe Hospital of Hubei University of Medicine from June 2011 to December 2012.The clinical data of the two groups were compared using the SPSS software.Results:There was no statistical difference in the location of tumor，surgical method，adjuvant chemotherapy，endocrine therapy，gene targeting therapy，molecular subtype and the positive expression of ER between the two groups（P>0.05）.The youth group exhibited longer diameter of tumor，clinical stage and the rates of lymph node metastasis were higher than elderly group（P<0.05）.In the youth group，the positive expression rates of HER-2 and Ki-67 were higher but the expression of PR were lower than elderly group（P<0.05）.The overall survival of the two groups were not difference（P>0.05）and the metastasis and recurrence in youth group were higher than elderly group during the follow-up（P<0.05）.Conclusion:Breast cancer in young patient has the character of high malignancy，strong invasion，rapid growth，early metastasis and usually has poor prognosis.