摘要/Abstract
摘要： 目的·探讨并分析不同年龄范围界定下年轻乳腺癌患者的临床病理特征、预后的差异及其影响因素。方法·回顾性分析2010年1月—2018年12月于上海交通大学医学院附属国际和平妇幼保健院诊治并行手术治疗的年龄≤ 40岁的浸润性导管癌女性患者277例。以35岁为界限，将患者分为≤ 35岁组和>35 且≤ 40岁组。比较2组患者临床病理特征间的差异，包括细胞组织学分级、肿瘤大小、淋巴结转移、雌激素受体（estrogen receptor，ER）表达、孕激素受体（progesterone receptor，PR）表达、人类表皮生长因子受体2（human epidermal growth factor receptor-2，HER2）表达、Ki-67表达、脉管内癌浸润程度、病理分期及分子分型，并对2组患者的预后差异及其影响因素进行分析。结果·≤ 35岁患者与>35 且≤ 40岁患者在细胞组织学分级、肿瘤大小、淋巴结转移、ER表达、PR表达、HER2表达、Ki-67表达、脉管内癌浸润程度、病理分期及分子分型间差异均无统计学意义。≤ 35岁患者与>35 且≤ 40岁患者的3年无病生存期（disease-free survival，DFS）分别为89.66%和95.03%，且差异无统计学意义；在各个分子分型中，2组患者的3年DFS间差异亦无统计学意义。Cox模型分析显示，脉管内癌浸润和淋巴结转移是DFS的独立危险因素。结论·>35 且≤ 40岁的乳腺癌患者与≤ 35岁的乳腺癌患者具有相似的临床病理特征及预后，应给予同样的治疗策略。
关键词: 年轻乳腺癌患者, 临床病理特征, 预后
Abstract:
Objective · To explore and analyze the differences of clinicopathological features and prognosis and influencing factors in young breast cancer patients in different age groups. Methods · A total of 277 female breast cancer patients with invasive ductal carcinoma under 40 years old who were diagnosed and treatedoperation at the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine Jan. 2010 to Dec. 2018 were retrospectively analyzed. The patients were divided into two groupsthe age of 35 years old, i.e. aged ≤ 35 group and aged >35 and ≤ 40 group. The differences of clinicopathological features were compared between the two groups, including histological classification of cells, tumor size, lymph node metastasis, estrogen receptor (ER) , progesterone receptor (PR) , human epidermal growth factor receptor-2 (HER2) , the of Ki-67, the degree of intravascular invasion, pathological stage and molecular subtype. The prognostic differences and influencing factors of the two groups were analyzed. Results · There were no significant differences in histological classification of cells, tumor size, lymph node metastasis, ER , PR , HER2 , the of Ki-67, the degree of intravascular invasion, pathological stage and molecular subtype between the two groups. The 3-year disease-free survival (DFS) of the patients in the aged ≤ 35 and >35 and ≤ 40 group were 89.66% and 95.03%, respectively, and there was no significant difference. There was no statistically significant difference in the 3-year DFS among the four molecular subtypes between the two groups. Cox proportional hazards model showed that intravascular invasion and lymph node metastasis were the independent risk factors of DFS. Conclusion · >35 and ≤ 40 year-old breast cancer patients and ≤ 35 year-old breast cancer patients have similar clinicopathological features and prognosis, so the same treatment strategy should be given.
Key words: young patient with breast cancer, clinicopathological feature, prognosis
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