老年女性乳腺癌患者临床病理特点分析  

Analysis of clinical and pathological characteristics of breast carcinoma in elderly female patients

作　　者：华彬[1] 陆旭[1] 李波[1] 陈悦[1] 肖文政[1] 

机构地区：[1]卫生部北京医院乳腺中心,100730

出　　处：《中华老年医学杂志》2013年第5期536-539,共4页Chinese Journal of Geriatrics

摘　　要：目的 分析老年女性乳腺癌患者临床及病理特点,以期为老年女性乳腺癌患者规范化临床诊断、治疗提供帮助. 方法 回顾性分析2011年1月至12月在北京医院乳腺中心诊断治疗的所有女性乳腺癌患者共178例,分为老年组（≥65岁,78例）和非老年组（＜65岁,100例）,记录患者一般临床特点、影像学诊断、手术方式和病理学诊断；采用SAS 9.1统计软件对两组资料进行分析. 结果 钼靶检查在老年组诊断乳腺影像报告及数据系统（BI-RAD） 4-5类的比例为82.1％,在非老年组为63.0％（P＜0.05）,超声和钼靶检查在老年组诊断准确率差异无统计学意义（P＞0.05）,而非老年组超声诊断准确率高于钼靶检查（P＜0.05）.老年组患者的并发疾病尤其是2种以上并发疾病明显多于非老年组（P＜0.05）；在老年组有14例进行了单纯乳腺切除手术（其中4例行单纯乳腺切除＋前哨淋巴结活检）,非老年组只有3例（P＜0.05）.手术后的病理诊断结果分析发现,2组在雌激素受体、孕激素受体、肿瘤大小、组织学分级、病理分期上均无统计学意义（均P＞0.05）；老年组淋巴结转移较非老年组少（P＜0.05）；Ki-67表达阳性率在老年组较非老年组低（P＜0.05）；CerbB-2（＋＋＋）在非老年组为24.0％,老年组为5.1％,差异有统计学意义（P＜0.05）；2组乳腺癌病理类型均以浸润性导管癌为主,但老年组混合型及其他类型的乳腺癌明显多于非老年组（P＜0.05）. 结论 超声及钼靶对老年女性乳腺癌的诊断均有较好的准确性,可在临床选用；老年人合并疾病较多,制定外科手术方案时经常会受到影响；部分预后指标在老年组和非老年组有差异,提示老年乳腺癌的预后较非老年要好.Objective To analyze the clinical and pathological characteristics of breast carcinoma in elderly female patients and to offer the standard clinical diagnosis and treatment for breast carcinoma.Methods A total of 178 patients admitted to Breast Center of Beijing Hospital from January to December 2011 were enrolled in this retrospective study.Patients were divided into non-elderly group and elderly group.Clinical features,imaging diagnosis,operation patterns and pathological diagnosis were recorded.The data were analyzed by using SAS 9.1 software.Results The patients diagnosed as breast carcinomas in BI-RAD 4-5 categories by mammography were much more in the elderly group than in the non-elderly group （82.1% vs.63.0%,P〈0.05）.The diagnostic accuracy rates of ultrasonography and mammography in the elderly group were comparable（P〉 0.05）,while in the non-elderly group,the diagnostic accuracy rate of ultrasonography was higher than that of mammography （P〈0.05）.The incidence of concurrent diseases was higher in the elderly group than in the non-elderly group （P〈0.05）.The patients undergoing breast resection operation were much more in the elderly group than in the non-elderly group （14 cases vs.3 cases,P〈0.05）.The pathological diagnosis analysis showed that there were no significant differences in the number of ER-positive cells and PR-positive cells,tumor size,histological grade,pathological stage between the two groups （all P〉0.05）.The incidence of lymph node metastasis was lower in the elderly group than in the non-elderly group （P〈0.05）.The percentage of Ki-67 positive cells was lower in the elderly group than in the non-elderly group （P〈0.05）.The percentage of CerbB-2 strongly positive （＋＋＋） cells was lower in the elderly group than in the non-elderly group （5.1 % vs.24%,P〈0.05）.The invasive ductal carcinoma was the major histological type of breast cancer in both two groups,but there were more mixed type and other type carcinomas in the elderly group

关 键 词：乳腺肿瘤 病理学 临床 

分 类 号：R737.9[医药卫生—肿瘤]