基于SEER数据库分析30岁以下乳腺癌患者的临床特征、生存情况及预后因素  

Analysis of the clinical characteristics,survival and prognostic factors of breast cancer patients under 30 years of age based on SEER database

作　　者：王文彦 刘佳祥 朱强[1] 商庆尧 杨琛轩 王丕琳[1] 王昕 王翔 WANG Wenyan;LIU Jiaxiang;ZHU Qiang;SHANG Qingyao;YANG Chenxuan;WANG Pilin;WANG Xin;WANG Xiang(Department of Breast,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Breast Surgical Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]首都医科大学附属北京天坛医院乳腺科,北京100070 [2]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院乳腺外科,北京100021

出　　处：《癌症进展》2022年第13期1320-1324,1328,共6页Oncology Progress

基　　金：国家自然科学基金(82072097);国家重点研发计划(2019YFE0110000);北京希望马拉松专项基金(LC2020A18);中国医学科学院医学与健康科技创新工程(2020-I2M-C&T-B-069)。

摘　　要：目的分析30岁以下乳腺癌患者的临床特征、生存情况及预后因素。方法应用美国国立癌症研究所监测、流行病学和最终结果(SEER)数据库检索并筛选出2010—2015年确诊的1903例30岁以下女性乳腺癌患者,分析其临床特征,采用Kaplan-Meier生存曲线分析乳腺癌患者总生存(OS)和乳腺癌特异性生存(BCSS)情况,采用Cox比例风险模型分析30岁以下乳腺癌患者预后的影响因素。结果1903例患者中,13~25岁457例,26~29岁1446例。13~25岁患者中人类表皮生长因子受体2(HER2)突变比例更高。中位随访时间为54个月,30岁以下乳腺癌患者的5年OS率和5年BCSS率分别为82.5%和83.9%。多因素Cox比例风险回归分析结果显示,年龄、T分期、N分期、M分期、手术方式、重建手术、放疗、化疗、雌激素受体(ER)表达情况、HER2表达情况以及分子分型均是30岁以下乳腺癌患者OS的独立影响因素(P﹤0.05),年龄、T分期、N分期、M分期、手术方式、放疗、化疗、HER2表达情况均是30岁以下乳腺癌患者BCSS的独立影响因素(P﹤0.05)。结论30岁以下乳腺癌患者具有独特的临床特征,ER、HER2、分子分型有助于评估预后。Objective To analyze the clinical characteristics,survival,and prognostic factors of breast cancer patients under 30 years of age.Method National Cancer Institute,Surveillance,Epidemiology,and End Results(SEER)database was used to screen out 1903 breast cancer patients under 30 years of age from 2010 to 2015.The clinical characteristics were analyzed,Kaplan-Meier analysis was used to analyze the overall survival(OS)and breast cancer-specific survival(BCSS),and Cox proportional hazard model was used to analyze the prognostic factors of breast cancer patients under 30 years of age.Result Among the 1903 patients,457 were 13-25 years of age,and 1446 were 26-29 years of age.The proportion of human epidermal growth factor receptor 2(HER2)mutation was higher in patients with 13-25 years of age.The median follow-up time was 54 months.The 5-year OS rate and 5-year BCSS rate were 82.5% and 83.9%,respectively in breast cancer patients under 30 years of age.Multivariate Cox proportional hazard regression analysis showed that age,T stage,N stage,M stage,surgery method,reconstruction surgery,radiotherapy,chemotherapy,estrogen receptor(ER)expression,HER2 expression,and molecular subtype were independent prognostic factors of OS in breast cancer patients under 30 years of age(P<0.05).Age,T stage,N stage,M stage,surgery method,radiotherapy,chemotherapy,HER2 expression were independent prognostic factors of BCSS in breast cancer patients under 30 years of age(P<0.05).Conclusion Breast cancer patients under the age of 30 have unique clinical characteristics.ER,HER2 and molecular subtype may help to predict the prognosis of patients.

关 键 词：乳腺癌 临床特征 预后 SEER数据库 

分 类 号：R737.9[医药卫生—肿瘤]