老年女性乳腺癌的临床病理特点与生存状况研究  

Study on clinicopathological characteristics and survival status of elderly women with breast cancer

作　　者：刘晓敏 郭康 李珍 唐海利 杨小军 陈宝莹 赵华栋 LIU Xiaomin;GUO Kang;LI Zhen;TANG Haili;YANG Xiaojun;CHEN Baoying;ZHAO Huadong(Thyroid and Breast Surgery,Xi′an International Medical Center Hospital;Outpatient Department Troops 93558 PLA;General Surgery,the Second Affiliated Hospital of the Fourth Military Medical University;Department of Imaging,Xi′an International Medical Center Hospital)

机构地区：[1]西安国际医学中心医院甲乳外科,陕西西安710100 [2]93558部队门诊部,河北石家庄050000 [3]第四军医大学第二附属医院普通外科,陕西西安710100 [4]西安国际医学中心医院影像科,陕西西安710100

出　　处：《中国妇幼健康研究》2021年第10期1395-1403,共9页Chinese Journal of Woman and Child Health Research

基　　金：陕西省2020年科技计划资助项目(NO.2020SF-049)。

摘　　要：目的分析老年女性乳腺癌患者的临床病理特点与生存状况。方法回顾性分析2013年1月至2018年1月期间在西安国际医学中心医院住院治疗的148例老年女性乳腺癌患者的临床资料。依据患者3年内生存情况分为死亡组(n=19)和生存组(n=129),对老年女性乳腺癌患者死亡的相关因素进行单因素和Logistic多因素分析。结果老年女性乳腺癌患者中年龄70~79岁(54.05%)、初潮年龄≥15岁(60.81%)、绝经年龄<55岁(88.51%)、初次生育年龄<30岁(72.98%)、左侧乳房肿瘤(51.35%)、有哺乳史(86.49%)、无恶性肿瘤家族史(75.68%)、无乳腺癌家族史(94.59%)、合并高血压(24.32%)、合并症为2个(37.16%)的患者占比例较高。老年女性乳腺癌患者以浸润性导管癌(70.26%)、病理Ⅱ期(45.27%)、组织学2级(56.08%)、病理T2分期(51.35%)、病理N0分期(57.43%)、无脉管癌栓(97.97%)、无高复发风险(81.08%)占比最高。老年女性乳腺癌患者以ER+(68.92%)、PR+(61.48%)、Her 2-(70.95%)、Ki-67未知(71.63%)、P53-(60.82%)、分子类型Lumnal A(68.92%)占比最高。Logistic多因素分析结果显示,年龄≥70岁、浸润性导管癌、病理N2和N3期、ER-、PR-、淋巴结转移、未化疗是老年女性乳腺癌患者死亡的危险因素(OR值1.737~3.673,P<0.05)。结论老年女性乳腺癌患者有特殊的临床病理特点,临床上应对年龄≥70岁、浸润性导管癌、病理N2和N3期、ER-、PR-、淋巴结转移、未化疗的患者加强监测,以提高患者生存率。Objective To analyze the clinicopathological characteristics and survival status of elderly women with breast cancer.Methods The clinical data of 148 elderly breast cancer patients hospitalized in Xi′an international medical center hospital from January 2013 to January 2018 were analyzed retrospectively.Patients were divided into the death group(n=19)and survival group(n=129)according to their survival within 3 years.The related factors of death in elderly women with breast cancer were analyzed by univariate and multivariate Logistic analysis.Results Elderly female with breast cancer aged 70-79 years(54.05%),menarche age≥15 years(60.81%),menopausal age<55 years(88.51%),age at first childbirth<30 years(72.98%),left breast Tumor(51.35%),breastfeeding history(86.49%),no family history of malignant tumor(75.68%),no family history of breast cancer(94.59%),hypertension(24.32%),2 complications(37.16%))accounted for a higher proportion.Elderly female with breast cancer with invasive ductal carcinoma(70.26%),pathologicⅡperiod(45.27%),histological grade 2(56.08%),pathologic T2 stage(51.35%),pathologic N0 stage(57.43%),vascular tumor emboli(97.97%),and no high risk of recurrence(81.08%)accounted for the highest proportion.In elderly female with breast cancer,ER+(68.92%),PR+(61.48%),Her 2-(70.95%),Ki-67 unknown(71.63%),P53-(60.82%)and molecular type Luminal A(68.92%)accounted for the highest proportion.Logistic multivariate analysis showed that age≥70 years old,invasive ductal carcinoma,pathological stage N2 and N3,ER-,PR-,lymph node metastasis,and no chemotherapy were the risk factors for death of elderly female with breast cancer(OR=1.737-3.673,P<0.05).Conclusion Elderly female with breast cancer have special clinicopathologic characteristics.Clinical monitoring should be strengthened for patients≥70 years old with invasive ductal carcinoma,pathological STAGE N2 and N3,ER-,PR-,lymph node metastasis,and without chemotherapy to improve patient survival rate.

关 键 词：乳腺癌 老年女性 临床病理特点 生存 相关因素 

分 类 号：R737.9[医药卫生—肿瘤]