年轻乳腺癌临床病理特征及其腋窝淋巴结转移的影响因素  

Clinicopathologic features of young patients with breast cancer and its influencing factors of axillary lymph node metastasis

作　　者：刘倩[1] 丁兀兀[1] 陈丽[1] 聂佳[1] 吴宁[1] 孟红[1] LIU Qian;DING Wu-wu;CHEN Li;NIE Jia;WU Ning;MENG Hong(Department of Pathology, People's Hospital of Deyang, Deyang 618000, Sichuan, CHINA)

机构地区：[1]德阳市人民医院病理科,四川德阳618000

出　　处：《海南医学》2019年第7期820-823,共4页Hainan Medical Journal

基　　金：四川省卫生厅科研课题(编号:100174)

摘　　要：目的探讨年轻乳腺癌(≤35岁)患者的临床病理特征、分子分型特征及腋窝淋巴结转移与雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2 (Her2)、细胞增殖指数(Ki-67)的关系,为年轻乳腺癌的个性化治疗以及临床结局的判断提供理论依据。方法回顾性分析德阳市人民医院2011年9月至2018年5月诊断的66例有完整临床病理资料的年轻原发性浸润性乳腺癌患者的临床病理特征、分子分型特征,并与同期诊断的100例年龄>35岁的非年轻组乳腺癌进行比较;同时分析年轻组乳腺癌腋窝淋巴结转移与ER、PR、Her-2、Ki-67的关系。结果年轻组及非年轻组乳腺癌患者在病理类型、组织学分级、TNM分期、PR的表达、HER2的表达以及Ki-67的表达水平方面比较差异均无统计学意义(P>0.05);年轻组肿瘤直径>2 cm患者所占比例为53.0%,明显高于非年轻组的36.0%,腋窝淋巴结转移率为60.6%,明显高于非年轻组的44.0%,ER阳性率为63.6%,明显低于非年轻组的78.0%,以上各项指标比较差异均具有统计学意义(P<0.05);在分子分型上,年轻组主要为Luminal B型(51.5%),而非年轻组主要为Luminal A型(44.0%);伴有淋巴结转移患者的HER2的阳性率和Ki-67高表达率分别为69.2%、76.9%,明显高于无淋巴结转移患者的30.0%和50.0%,差异均有统计学意义(P<0.05)。结论与非年轻组乳腺癌比较,年轻乳腺癌肿瘤直径更大、更容易发生腋窝淋巴结转移、ER阳性率低、分子分型主要为Luminal B型。年轻乳腺癌HER2阳性表达、Ki-67高表达患者容易发生腋窝淋巴结的转移。Objective To investigate the relationship between clinicopathological features, molecular typing,axillary lymph node metastasis and estrogen receptor(ER), progesterone receptor(PR), and human epidermal growth factor receptor 2(Her2), cell proliferation index(Ki-67) in young breast cancer patients(≤35 years old), in order to provide a theoretical basis for the personalized treatment of young breast cancer and the evaluation of clinical outcomes.Methods The clinical and pathological features of 66 young breast cancer patients(≤35 years old) diagnosed by Deyang People’s Hospital from September 2011 to May 2018 was retrospectively analyzed, and were compared with that of100 non-young patients with breast cancer(over 35 years old) diagnosed in the same period. The relationship between the axillary lymph node metastasis of the young group and the ER, PR, Her-2, and Ki-67 was analyzed. Results There were no significant differences in pathological type, histological grade, TNM stage, PR expression, HER2 expression,and Ki-67 expression between young and non-young breast cancer patients(P>0.05). The proportion of patients with tumor diameter >2 cm in young group was 53.0%, which was significantly higher than 36.0% in non-young group. The rate of axillary lymph node metastasis in young group was 60.6%, which was significantly higher than 44.0% in non-young group. ER positive rate in young group was 63.6%, significantly lower than 78.0% of the non-young group.The differences in the above indicators between the two groups were statistically significant(P<0.05). In molecular typing, the young group was mainly luminal B type(51.5%), while the non-young group was mainly luminal type A(44.0%). The positive rate of HER2 and the expression rate of Ki-67 were 69.2% and 76.9% in patients with lymph node metastasis, significantly higher than 30.0% and 50.0% in patients without lymph node metastasis(P<0.05).Conclusion Compared with non-young breast cancer, breast cancer tumors in young patients are larger in diameter,more prone t

关 键 词：乳腺肿瘤 临床病理 年轻患者 免疫组化 腋窝淋巴结转移 

分 类 号：R737.9[医药卫生—肿瘤]