宿迁地区65岁以上乳腺癌684例临床病理特征及疗效调查分析

摘要

目的 调查分析宿迁地区老年性乳腺癌患者的临床病理特征及治疗效果.方法 收集宿迁地区诊治的684例65岁以上乳腺癌患者的病历资料,对患者的病理分型特征及治疗方法进行调查、分析并总结.结果 根据患者的病理分型将684例患者分为直接手术组(n=378)和新辅助治疗组(n=306),比较两组1、3、5年无病生存率(DFS)和总生存率(OS).684例65岁以上患者中,Luminal A型132例,占19.30％(164/684);Luminal B型324例,占47.37％(324/684),其中Luminal BⅠ型283例,占41.37％(283/684),Luminal BⅡ型(所谓三阳性)41例,占5.99％(41/684);Her-2过表达型132例,占19.30％;三阴性乳腺癌(TNBC)96例,占14.04％.新辅助化疗患者近期疗效:病理完全缓解(pCR)22例,临床完全缓解(cCR)30例,部分缓解(PR)106例,稳定(SD)80例,疾病进展(PD)28例;新辅助内分泌患者近期疗效:pCR 3例,cCR 2例,PR 6例,SD 2例,PD 20例;新辅助靶向治疗患者近期疗效:pCR 1例,cCR 1例,PR 5例,SD 0例,PD 0例.新辅助治疗患者的远期疗效:1年无病生存期(DFS)、总生存期(OS)均为100％;1年DFS为100％,2年DFS为84.72％,3年DFS为76.31％,5年DFS为66.41％;1年OS为100％,2年OS为94.72％,3年OS为86.31％,5年OS为76.41％.直接手术组患者1年DFS为92.73％,2年DFS为76.59％,3年DFS为60.63％,5年DFS为57.22％;1年OS为100％,2年OS为85.65％,3年OS为74.71％,5年OS为48.33％.结论 老年性乳腺癌患者经历新辅助治疗后再实施手术者DFS、OS明显优于直接手术者;宿迁地区老年性乳腺癌Luminal B型患者多于Luminal A型患者,而Her-2过表达型和三阴性乳腺癌比例与国内外报道一致.%Objective To investigate the clinical pathological types and efficacy of senile breast cancer in Suqian area. Methods The clinical data of breast cancer patients aged above 65 years old in Suqian area were collected. The pathological types and therapy were evaluated and summarized. Results A total of 684 cases were divided into two groups by pathological types,neoadjuvant therapy group (n = 306)and surgery group (n = 378). The one-year,3-year and 5-year disease-free survival (DFS)and overall survival (OS)were compared between the two groups,132 cases with Luminal A, accounting for 19. 3％ (132 / 684),324 cases with Luminal B,accounting for 47. 37％ (324 / 684),of 283 cases of Luminal B Ⅰ,accounting for 41. 37％ (283 / 684),41 cases of Luminal B Ⅱ,accounting for 5. 99％ (41 / 684);132 cases with Her-2 over-expression,accounting for 19. 30％;96 cases with Triple negative breast cancer (TNBC),accounting for 14. 04％ . The short-term efficacy of neoadjuvant therapy of 306 patients:among the patients with neoadjuvant chemotherapy,22 cases of pCR,30 cases of cCR,106 cases of PR,80 cases of SD,28 cases of PD;among the patients with neoadjuvant endo-crine therapy,3 cases of pCR,2 cases of cCR 6 cases of PR,2 cases of SD,20 cases of PD;among of patients with neoadjuvant targeted therapy,1 case of pCR,1 case of cCR,5 cases of PR,0 case of SD, 0 case of PD. The long-term efficacy of neoadjuvant therapy of 306 patients;1-year DFS and OS were 100％,2-year DFS was 84. 72％,3-year DFS was 76. 31％,5-year DFS was 66. 41％;,2-year OS was 94. 72％,3-year OS was 86. 31％,5-year OS was 76. 41％ . The long-term efficacy of surgery therapy of 378 patients:1-year DFS was 92. 73％,2-year DFS was 76. 59％,3-year DFS was 60. 63％,5-year DFS was 57. 22％,1-year OS was 100％,2-year OS was 85. 65％,3-year OS was 74. 71％,5-year OS was 48. 33％ . Conclusions DFS and OS of senile patients with breast cancer who underwent neoadju-vant therapy were significantly superior to those of surgery therapy. Senile patients with breast cancer of Luminal B were more than those of Luminal A in Suqian area,and the proportion of Her-2 over expres-sion and triple negative breast cancer is consistent with that reported at home and abroad.