年轻与中老年双侧原发性乳腺癌的临床病理学特征及预后分析  

Analysis on clinicopathological features and prognosis of bilateral primary breast cancer between young patients and middle-old patients

作　　者：孙萌 王新星[1] 薛兵建 张玉杰[1] 李凯强 甘丽 解钧媛 裴新红[1] SUN Meng;WANG Xinxing;XUE Bingjian;ZHANG Yujie;LI Kaiqiang;GAN Li;XIE Junyuan;PEI Xinhong(Department of Breast Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,P.R.China)

机构地区：[1]郑州大学第一附属医院乳腺外科,郑州450052

出　　处：《中国普外基础与临床杂志》2022年第5期632-640,共9页Chinese Journal of Bases and Clinics In General Surgery

基　　金：河南省高等学校重点科研项目计划(项目编号:18A320017)。

摘　　要：目的探究不同年龄双侧原发性乳腺癌(bilateral primary breast cancer,BPBC)的临床病理学特征及预后。方法收集2017年1月至2020年1月期间郑州大学第一附属医院乳腺外科连续收治的105例BPBC患者的临床病理及随访资料,按照年龄分为年轻组(≤40岁)和中老年组(>40岁),回顾性分析2组患者双侧病灶的病理学类型、分子分型、肿瘤直径、组织学分级、临床分期、淋巴结转移、复发或远处转移、免疫组织化学指标表达的特征及一致性和差异以及总体预后。结果2组患者在第一原发癌灶大小和淋巴结转移情况、第二原发癌Ki-67高表达率、双原发癌的临床分期以及复发或远处转移方面的差异均有统计学意义(P<0.05),年轻组第一原发癌为T3~T4期者占比高、淋巴结转移率高,第二原发癌Ki-67高表达者占比高,双原发癌首诊为Ⅳ期的患者占比高于中老年组且容易发生复发或远处转移。2组双侧癌灶免疫组织化学指标表达均存在一致性(P<0.05),年轻组的ER和Ki-67表达一致性更好,中老年组的PR和HER-2表达一致性更好。第一原发癌的组织学分级、双侧原发癌的TNM分期以及复发或转移是影响患者预后的因素(P<0.05)。结论不同年龄BPBC患者具有不同的临床病理学特征,双侧癌灶免疫组织化学指标表达均具有一致性。第一原发癌的组织学分级可能影响BPBC患者的预后,双侧癌灶TNM分期早的患者预后更佳。Objective To explore the clinicopathological features of bilateral primary breast cancer(BPBC)at different ages.Methods Clinical data of 105 BPBC patients admitted to the Department of Breast Surgery in The First Affiliated Hospital of Zhengzhou University from January 2017 to January 2020 were collected and divided into young group(≤40 years old)and middle-old group(>40 years old)according to age.The characteristics and differences of bilateral tumor lesions in pathological type,molecular type,tumor diameter,histological grade,clinical stage,lymph node metastasis,recurrence or distant metastasis,immunohistochemical indexes expression characteristics,consistency and difference,and overall prognosis between the two groups were retrospectively analyzed.Results There were statistically significant differences between the two groups in the size of the first primary cancer,lymph node metastasis,the high expression rate of Ki-67 in the second primary cancer,clinical stage of double primary cancer and recurrence or distant metastasis(P<0.05).In the young group,the proportion of the first primary cancer with T3–T4 stage was higher,the incidence of lymph node metastasis was higher,the proportion of high expression of Ki-67 in the second primary cancer was higher,and the proportion of patients with double primary cancer at first diagnosed as stageⅣwere higher than those in the middle-old group,and were prone to recurrence or distant metastasis.The expression of immunohistochemical indexes in bilateral cancer foci was consistent between the two groups(P<0.05).The expression consistency of ER and Ki-67 in the young group was better,and the expression consistency of PR and HER-2 in the middle-old group was better.The histological grade of the first primary cancer,TNM stage of bilateral primary cancer and recurrence or metastasis were independent factors affecting the prognosis of patients(P<0.05).Conclusions The BPBC patients of different ages have different clinicopathological features,and the expression of immunohisto

关 键 词：双侧原发性乳腺癌 年轻患者 中老年患者 临床病理学特征 预后 

分 类 号：R737.9[医药卫生—肿瘤]