35岁以下女性乳腺癌患者的临床病理特征  

Clinical and pathological characteristics of breast carcinoma in women aged 35 years or younger

作　　者：孙莹[1] 于晶 魏军民[1] 樊聪[1] 王秀问[1] 高鹏[3] 江立玉[4] 马婷婷[4] 

机构地区：[1]山东大学齐鲁医院肿瘤中心化疗科,山东济南250012 [2]山东医学高等专科学校,山东济南250002 [3]山东大学齐鲁医院病理科,山东济南250012 [4]山东大学齐鲁医院乳腺外科,山东济南250012

出　　处：《山东大学学报（医学版）》2014年第7期71-74,共4页Journal of Shandong University:Health Sciences

摘　　要：目的分析35岁以下女性乳腺癌患者的临床病理特征。方法回顾分析山东大学齐鲁医院2007年1月1日至2012年12月31日收治的153例35岁以下乳腺癌的发病特点及各分子型的临床病理特征。结果该组患者首发症状以乳房肿块为主,107例(69.9%)在出现症状后半年内就诊。153例中导管内癌22例(14.4%),浸润性癌131例(85.6%)。131例浸润性癌根据免疫组化分为腔面A型30例(22.9%),腔面B型65例(49.7%),Her-2过表达型18例(13.7%),基底样型18例(13.7%)。131例浸润性癌组织学分级以Ⅱ/Ⅲ级为主,分别为76例(58.0%)和32例(24.4%);腔面A型初诊时直径≤2 cm和组织学分级Ⅰ级的肿瘤所占比例较其他型高;各型淋巴结转移数及临床分期均无统计学差异(P>0.05)。浸润性乳腺癌患者Ki67阳性率高,平均值为(30.12±3.91)%。结论年轻女性乳腺癌患者初诊时分期较晚;肿瘤直径、组织学分级与乳腺癌分子分型密切相关;Ki67阳性率较高,且预后差的分子分型所占比例较高,提示年轻女性乳腺癌患者预后较差,应重视年轻女性乳腺癌的早期诊断。Objective To analyze the clinical and pathological features of breast cancer in women under 35 years of age. Methods 153 breast cancer patients aged 35 or younger treated from Jan. 1,2007 to Dec. 31,2012 were retrospectively reviewed. The characteristics of breast cancer onset and clinical and pathological features in different molecular subtypes of breast cancer were analyzed by SPSS 17. 0 statistics software. Results The most common symptom among young patients was breast lumps,and 107（ 69. 9%） of the patients went to the hospital within six months as soon as the symptom was appeared. Among these 153 samples,22（ 14. 4%） were diagnosed as having ductal carcinomas in situ,and 131（ 85. 6%） had invasive cancers. In addition,based on immunohistochemistry,the invasive cancers were categorized into four molecular subtypes： luminal A（ 30,22. 9%）,luminal B（ 65,49. 7%）,Her-2over-expression（ 18,13. 7%） and basal-like（ 18,13. 7%）. The most invasive cancers were in histological grades Ⅱ（ 76,58.0%） and Ⅲ（ 2,24.4%）. In luminal A subtype,the diameter≤2cm and histological gradeⅠranked higher than in any other subtypes. There were no significant differences among different subtypes regarding lymph node metastasisand clinical stage. The invasive cancers had a high positive rate of Ki67,with an average of（ 30. 12 ± 3. 91） %.Conclusion The clinical stages of young breast cancer patients are more advanced; tumor diameter and histological grade are closely related with molecular subtypes; the high positive rate of Ki67 and the high proportion of the molecular subtypes with adverse prognosis imply poor prognosis. We should pay more attention on the early diagnosis of young patients.

关 键 词：乳腺肿瘤 年轻女性 分子分型 临床特征 病理特征 

分 类 号：R737.9[医药卫生—肿瘤]