年轻乳腺癌患者临床病理特征及预后分析

摘要

Objective To explore the difference of clinicopathological characteristics and prognosis of young breast cancer with different molecular subtypes and the influential factors of the prognosis of young breast cancer patients.Methods Clinical data of 81 young patients with breast cancer(age ≤ 35 years old)from our hospital in 2007-2011 were collected and retrospectively analyzed.Results The recurrence and metastasis had statistical difference among patients with three different molecular subtypes.Among patients with three molecular subtypes,the age of patient,family history of cancer,tumor diameter,number of lymph nodes,pathological type and TNM staging had no significant difference.The follow-up survival time was 6-91 months.The overall survival rates was 81.9％,66.3％,58.4％ in Luminal subtype group,HER-2 positive group,and three negative subtype group,respectively(P ＜ 0.05),and the disease-free survival rates between three groups had no obvious difference (P ＞ 0.05).The age,tumor size,lymph node metastasis,postoperative recurrence and metastasis were the main factors influencing the prognosis of young breast cancer(P ＜ 0.05).Number of lymph node metastasis,postoperative recurrence,transfer condition were the independent risk factors affecting the prognosis of young breast cancer patients (P ＜ 0.05).Conclusion Different molecular subtypes of young breast cancer have complex pathology and biology characteristics.Early diagnosis and systemic comprehensive treatment should be paid more attention to improve the prognosis.%目的 探讨不同分子分型年轻乳腺癌的临床病理特点及预后差异,分析影响年轻乳腺癌患者预后的因素,为临床诊治提供指导意义.方法 选取81例2007-2011年我院收治的年轻乳腺癌(年龄≤35岁)患者的临床病理资料,回顾性分析Luminal型、HER-2阳性型、三阴型的年轻乳腺癌的临床病理特征及预后情况.结果 Luminal型、HER-2阳性型、三阴型患者复发转移情况存在统计学差异.不同分子分型患者在年龄、是否有肿瘤家族史、肿瘤直径、淋巴结数目、病理类型、TNM分期等分布并无统计学差异.随访生存时间6-91个月,Luminal型、HER-2阳性型、三阴型总生存率分别为81.9％,66.3％,58.4％,组间差异有统计学意义(P＜0.05),三组无病生存率组间无明显差异(P＞0.05).年龄、肿瘤大小、淋巴结转移数目、术后复发和转移的情况是影响年轻乳腺癌预后的主要因素(P＜0.05).淋巴结转移数目、术后复发转移状况是影响患者预后独立危险因素(P＜0.05).结论 不同分子分型的年轻乳腺癌具有复杂的病理学及生物学特征,总体预后较差,淋巴结转移数目、术后复发转移状况对预后影响较大,应重视早期发现及全身综合治疗,以期改善预后.