乳腺癌患者发病年龄和临床病理学参数的相关性研究

目的　根据乳腺癌组织病理学分级和ＨＥＲ ２过表达状态，研究早发性乳腺癌的分类方法及与早发性乳腺癌有关的临床病理学参数。方法　选取２０００年１月之后就诊于长海医院乳腺癌患者２２３２例，按照每增加５岁为一个发病年龄分层，分为＜３０岁、３０～３４岁、３５～３９岁、４０～４４岁、４５～４９岁和≥５０岁６个层次。首先，研究不同发病年龄和组织病理学分级之间的关系，筛选出有意义的年龄层；然后，再将ＨＥＲ-２表达作为筛选因素，进一步剔除和ＨＥＲ-２表达状态无关的年龄层。通过两步筛选，在６个连续的发病年龄分层中选择与组织病理学３级和ＨＥＲ-２过表达有关的发病年龄分界点。最后，根据拟定的早发性乳腺癌的分类方法，综合分析与早发性乳腺癌有关的临床病理学参数。结果　当发病年龄＜３５岁时，发病年龄与肿瘤组织学分级和ＨＥＲ-２表达均有关，判断３５岁可作为早发性乳腺癌的年龄分界点，＜３５岁发病可定义为早发性乳腺癌，其特点包括原发肿瘤体积大、淋巴结转移数目多、ＡＪＣＣ分期晚，ＨＥＲ-２阳性以及激素受体阴性表达比例高。结论　乳腺癌＜３５岁发病定义为早发性乳腺癌具有代表性，它与发病年龄晚的乳腺癌不同，早发性乳腺癌ＥＲ／ＰＲ阳性率低，ＨＥＲ-２过表达比例高，组织学３级居多。

Association between age and clinicopathological features of breast cancer patients

Objective In this study,firstly the optimal age at diagnosis was identified to differentiate the early-onset breast cancer patients.The associations between the age at diagnosis and clinicopathological features were analyzed.Methods Two thousand two hundred and thirty-two cases with invasive breast cancer in Changhai Hospital of Shanghai were analyzed,which were stratified into 6 groups by age range of 5 years from 30 to 50 years and justified which age was the best resection for association between histolo...