小于35岁153例进展期乳腺癌患者的临床特征和预后  

Clinical features of 153 female patients with advanced breast cancer under 35 years of age and their prognosis analysis

作　　者：冉然[1] 李惠平[1] 严颖[1] 刘笑然[1] 张如艳[1] 孔维垚 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所,乳腺肿瘤内科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《肿瘤》2017年第1期77-82,共6页Tumor

基　　金：国家自然科学基金资助项目(编号:81502269)~~

摘　　要：目的 :分析小于35岁进展期乳腺癌患者的分子类型和转移特征,并探讨影响预后的因素。方法 :回顾性分析2011年1月至2016年1月在北京大学肿瘤医院就诊的发病年龄小于35岁的153例进展期乳腺癌患者,对其预后相关因素进行单因素和多因素分析。结果 :本组患者中位发病年龄为31.7岁,中位无病生存期为28.4个月。153例患者中,有直系肿瘤家族史24例(15.7%),初治Ⅳ期11例(7.2%);首发转移部位以骨转移最常见,为63例(41.2%)。随访至2016年4月,中位生存期为31.3个月,5年生存率为18.1%。多因素分析结果显示,直系肿瘤家族史、雌激素受体阴性、孕激素受体阴性、肿瘤体积较大是独立的不良预后因素(P值均<0.05)。结论 :进展期年轻乳腺癌受年龄因素影响,预后明显变差。肿瘤较大、激素受体阴性和肿瘤直系家族史是其独立的不良预后因素。Objective： To explore the molecular type, metastasis characteristics and the prognostic factors of advanced breast cancer in women under 35 years of age. Methods： Retrospective analysis on clinical data of 153 patients from January 2011 to January 2016 treated in Department of Breast Oncology, Peking University Cancer Hospital was carried out in this study. Univariate and multivariate analyses were conducted using Kaplan-Meier method and COX hazard model, respectively. Results： The median age of this cohort was 31.7 years, with a median disease-free survival （DFS） of 28.4 months. Of the 153 patients, 24 patients （15.7%） had the immediate family history of tumor, and 11 patients （7.2%） were diagnosed with initial TNM stage IV. Bone metastasis was observed in 63 patients （41.2%）, and was most commonly seen in first metastasis. By the end of April 2016, the median survival time was 31.3 months, and the 5-year survival rate was 18.1%. Multivariate analysis revealed that the immediate family history of tumor, estrogen receptor （ER）-negative, progesterone receptor （PR）- negative, and larger tumor volume were the independent adverse prognostic factors （all P 〈 0.05）. Condusion： The prognosis of advanced breast cancer in young women is significantly affected by the age at the diagnosis, and is worse than other subtypes of breast cancer. Larger tumor volume, hormone receptor-negative and immediate family history of tumor are independent adverse prognostic factors.

关 键 词：乳腺肿瘤 进展期乳腺癌 直系肿瘤家族史 雌激素受体 孕激素受体 年轻人 

分 类 号：R737.3[医药卫生—肿瘤]