77例25岁以下女性乳腺癌临床特点及预后分析  

Clinicopathological features and prognostic factors of breast cancer in women aged under 25 years: a report of 77 cases

作　　者：张艳琦[1] 张丽娜[1] 顾林[1] 

机构地区：[1]天津医科大学肿瘤医院乳腺二科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,乳腺癌防治教育部重点实验室,天津市300060

出　　处：《中国肿瘤临床》2013年第24期1548-1552,共5页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金(编号:81202275);天津医科大学科学基金(编号:2011KY11)资助~~

摘　　要：目的:探讨年轻患者乳腺癌的临床病理特点、诊治要点和预后。方法:回顾性分析1995年1月至2010年1月天津医科大学肿瘤医院收治的77例25岁以下女性乳腺癌患者的临床及病理资料,并对患者年龄、是否哺乳期、肿瘤大小、淋巴结转移、手术方式、分期、免疫组化指标及治疗等因素与预后的关系进行统计学分析。Kaplan-Meier法比较生存差异,组间比较采用Log-rank检验,多因素分析采用Cox比例风险回归模型。结果:77例患者平均年龄(22.94±1.94)岁,均经病理组织检查确诊。随访中27例患者出现复发或转移,其中18例患者因肿瘤复发转移死亡。中位总生存时间为39个月,中位无进展生存时间为36个月,Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者的3年生存率分别为100%、92.44%、59.97%、0,5年生存率分别为100%、86.84%、59.97%、0。单因素分析显示:肿瘤大小、淋巴结转移、手术方式、病理分期及雌激素受体状态是影响患者预后的因素,是否为哺乳期、PR、HER-2、p53、分子分型、化疗、放疗与预后无关。多因素分析显示淋巴结转移情况是影响预后的独立因素。结论:年轻乳腺癌发病率低,其生物学行为、病理及预后等方面有其特点。淋巴结转移情况是影响预后的独立因素与早期诊断与早期治疗是预后的关键。Objective：To improve the recognition, appropriate diagnosis, and treatment of breast cancer in women aged 25 years or less through their clinicopathological features, diagnosis, treatment, and prognosis. Methods：The clinicopathological data from 77 patients with breast cancer treated in our hospital between January 1995 and January 2010 were retrospectively reviewed. The correla-tion between age, lactation, tumor size, axillary node status, surgical approach, pathological stage, indicators of immunohistochemistry treatment modality, and prognosis was analyzed using statistical software. Results：All patients were female, and their average age was 22.94 ± 1.94 years. The diagnosis depended on pathological examination. In the follow-up visits, recurrence or metastasis was found in 27 patients, of which 18 died . The median overall survival was 39 months, and the median progression-free survival was 36 months. The 3 year overall survival rates of stagesⅠ,Ⅱ,Ⅲ, andⅣwere 100%, 92.44%, 59.97%, and 0, respectively. The 5 year overall sur-vival rates of the four stages were 100%, 86.84%, 59.97%, and 0, respectively. Univariate factor analysis showed that tumor size, axil-lary lymph node status, surgical approach, pathological stage, and estrogen receptor were impact factors, whereas lactation, progester-one receptor, human epidermal growth factor receptor-2, p53, molecular subtyping, chemotherapy, and radiotherapy were not. Cox mul-tivariate analysis showed that axillary lymph node status was an independent prognostic factor for breast cancer in women aged 25 years or less. Conclusion：Breast cancer in young women is rare and has unique characteristics in biological behaviors, diagnosis, prognosis, and other factors. Axillary lymph node status was an independent prognostic factor. The crucial factors in the treatment were diagnosis and on time and early-stage treatment.

关 键 词：乳腺癌 年轻 诊断 治疗 预后 

分 类 号：R737.9[医药卫生—肿瘤]