25岁以下极年轻乳癌病人临床病理特征及预后分析  

Clinicopathological features and prognostic factors of very young breast cancer patients aged under 25 years

作　　者：高然 方仪 高纪东 GAO Ran;FANG Yi;GAO Jidong(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]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 [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深圳医院乳腺外科,北京100021

出　　处：《青岛大学学报（医学版）》2024年第3期412-416,共5页Journal of Qingdao University(Medical Sciences)

基　　金：中国癌症基金会北京希望马拉松专项基金项目(LC2019L07)。

摘　　要：目的 探讨25岁以下极年轻乳癌(VYBC)病人的临床病理特征与预后因素。方法 筛选美国监测、流行病学和最终结果(SEER)数据库中25岁以下女性乳癌病人共399例,采用χ^(2)检验和Cox比例风险回归模型对纳入病人的临床病理特征及预后影响因素进行分析。结果 纳入研究399例病人的2、3、5和10年总生存率分别为94.6%、91.3%、86.6%和78.7%。在≤20岁和21~25岁两组病人中,雌激素受体(ER)状态和分子分型的构成比有显著差异(χ^(2)=5.289,P<0.05;Fisher确切概率法,P=0.031)。不同分子分型病人组织学分级(χ^(2)=55.692,P<0.001)、临床病理分期(P=0.024)和T分期(P=0.001)等特征比较差异均有统计学意义。多因素分析显示,ER状态和T分期、N分期和M分期等特征是影响VYBC病人总生存期(OS)的独立预后因素(HR=0.385~6.532,95.0%CI=(0.150~2.644)~(0.985~16.964),P均<0.05),而手术方式等其他变量不是影响OS的独立预后因素(P均>0.05)。结论 ER状态、T分期、N分期和M分期等因素有助于临床初步预测25岁以下VYBC病人的生存预后;手术方式的选择与VYBC病人的OS无关。Objective To investigate the clinicopathological features and prognostic factors of very young breast cancer(VYBC)patients aged under 25 years.Methods A total of 399 female breast cancer patients aged under 25 years were obtained from the Surveillance,Epidemiology,and End Results database.The chi-square test and the Cox proportional-hazards regression model were used to analyze the clinicopathological features and prognostic factors of the patients included in this study.Results The 2-,3-,5-,and 10-year overall survival rates of the 399 patients were 94.6%,91.3%,86.6%,and 78.7%,respectively.There were significant differences in estrogen receptor(ER)status and the composition ratio of molecular subtypes between the≤20 years group and the 21-25 years group(χ^(2)=5.289,P<0.05;the Fisher’s exacttest:P=0.031).There were significant diffe-rences in histological grading(χ^(2)=55.692,P<0.001),clinicopathological staging(P=0.024),and T stage(P=0.001)between the patients with different molecular subtypes.The multivariate analysis showed that ER status,T stage,N stage,and Mstage were independent prognostic factors for the overall survival(OS)of VYBC patients(HR=0.385-6.532,95.0%CI=(0.150-2.644)to(0.985-16.964),all P<0.05),while surgical methods and other variables were not independent prognostic factors for OS(all P>0.05).Conclusion ER status,T stage,N stage,and M stage can help to predict the survival and prognosis of VYBC patients in clinical practice,and the selection of surgical procedure is not associated with the OS of VYBC patients.

关 键 词：乳房肿瘤 青年人 病理学 临床 预后 比例危险度模型 数据库 事实型 

分 类 号：R737.9[医药卫生—肿瘤] R365[医药卫生—临床医学]