65岁以上中国老年女性原发性乳腺癌临床病理特征及治疗分析:多中心10年回顾性研究  

Clinicopathologic Characteristics and Treatment Patterns of Primary Breast Cancer in Elderly Women:A Retrospective Multicenter Study

作　　者：闫宇[1] 任予[1] 范金虎[2] 张斌[3] 杨红建[4] 谢小明[5] 唐中华[6] 李卉[7] 李佳圆[8] 王淑莲[2] 乔友林[2] 何建军[1] 

机构地区：[1]西安交通大学第一附属医院,陕西西安710061 [2]中国癌症中心/中国医学科学院北京协和医学院肿瘤医院,北京100021 [3]辽宁省肿瘤医院,辽宁沈阳110046 [4]浙江省肿瘤医院,浙江杭州310022 [5]中山大学附属肿瘤医院,广东广州510050 [6]中南大学湘雅二院,湖南长沙410016 [7]四川省肿瘤医院,四川成都610047 [8]四川大学华西公共卫生学院,四川成都610044

出　　处：《中国肿瘤》2017年第7期561-566,共6页China Cancer

摘　　要：[目的]研究65岁以上老年女性原发性乳腺癌的风险暴露因素、临床病理特征以及治疗特征,为老年女性乳腺癌的诊治提供依据。[方法]回顾性分析全国7个不同地区具有代表性的7家医院收集的4211例乳腺癌患者信息,将65岁以上患者作为研究对象(老年组),50~64岁年龄组作为对照组。统计学方法为卡方检验和Fisher精确检验,P<0.05具有统计学意义。[结果]65岁以上老年乳腺癌患者占同期乳腺癌患者的8.33%(351/4211)。平均诊断年龄和平均绝经年龄分别为70.2岁(65~86岁)和49.59岁(32~58岁)。与对照组相比,老年组具有以下特征:以体力工作、生育大于一胎、低学历、结婚早和初次生育年龄早者显著;临床病理特征方面,老年患者区域淋巴结转移少、分期早(即更多的0+Ⅰ+Ⅱ期患者)、激素受体阳性率高、Her-2低表达、Her-2亚型和三阴性亚型少。在侵袭性治疗方面,老年患者较少接受改良根治术、保乳术、放疗、化疗,更多的是接受乳腺单纯切除术。两组间内分泌治疗无显著差异。[结论]老年乳腺癌患者有较好的临床病理特征和生物学行为;接受侵袭性治疗少;内分泌治疗需要加强。[Purposel To investigate the clinicopathological characteristics and therapeutic patterns of breast cancer in elderly women. [Methods] The medical records of 4211 female patients with breast cancer were collected from 7 representative regions of China from 1999 to 2008. Data of risk factors, clinicopathological characteristics and treatment patterns were extracted and analyzed. [Results] Of 4211 patients,351 （8.33%） patients were I〉65 years of age （elderly group）. In elderly group the mean age at the diagnosis was 70.2 years（65-86 years） and the mean age of menopause was 49.6 years（32-58 years）. Compared to patients aged 50-64 years （control group）, a larger proportion of patients in elderly group engaging in manual labors（P=0.034）,having nmhiple birth（P〈0.001）,younger primiparous age（P= 0.001） and less school education （P=0.018）. Compare to control group,the elderly patients had axillary lymph node metastasis less frequently（P=0.001）,more early-stages（stage 0, Ⅰ and Ⅱ） disease（P=0.030）, less Her-2 overexpression （P=0.005）,more ER/PR positivity （P=0.012）;for molecular subtypes,elderly patients had less Her-2 phenotype（P〈0.001） and less basal-like phenotype（P〈0.001）. Compared to con- trol group,lower proportion of elderly patients received modified radical mastectomy （P〈0.001）,breast- conserving surgery （P〈0.001）, chemotherapy （P〈0.001） and radiotherapy （P〈0.001）, while the elderly pa- tients had simple mastectomy more frequently（P〈0.001）,and less endocrine therapy. [Conclusion] El- derly breast cancer patients have a more favorable clinieopathologic profile and receive less aggressive therapy as compared to the younger counterparts. However, endocrine therapy needs to be strengthened.

关 键 词：乳腺癌 老年人 女性 临床病理学 治疗 回顾性研究 

分 类 号：R737.9[医药卫生—肿瘤]