不同分子分型青年乳腺癌的临床特点及预后因素分析

摘要
图/表
参考文献(26)
相关文章 (15)

全文: PDF (531 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨35岁及以下不同分子分型乳腺癌患者的临床病理特点与预后差异，并分析影响预后因素。方法回顾性分析2007年2月～2014年1月湖北省十堰市太和医院治疗的青年乳腺癌患者（≤35岁）的89例临床资料，分析其临床病理特点及预后影响因素。结果青年乳腺癌患者手术治疗86例，解救性治疗3例。手术患者中Luminal A型21例，Luminal B型16例，HER-2过表达型11例，三阴性乳腺癌38例，浸润性导管癌73例，临床分期Ⅱ期为54.6%和Ⅲ期为24.4%。各分子分型在肿瘤大小、临床分期、Ki67、淋巴结转移等指标的比较，差异无统计学意义（P ＞ 0.05）。随访3年和5年各分子分型的复发转移及生存率比较，差异无统计学意义（P ＞ 0.05）。肿瘤大小、淋巴结转移、Ki67、年龄和临床分期是影响青年乳腺癌预后的主要因素（P ＜ 0.05），其中淋巴结转移、肿瘤大小、临床分期是影响预后的独立危险因素（P ＜ 0.05）。结论青年乳腺癌以三阴性患者居多，临床分期较晚，肿瘤大小与淋巴结转移对预后影响较大，需早诊断早治疗，以期提高预后，但分子分型对预后的影响还需进一步研究。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	艾勇彪袁杰李文仿王群

关键词 ：乳腺癌, 青年, 分子分型, 预后

Abstract：Objective To investigate the clinicopathological characteristics and prognostic differences of patients with different molecular types of breast cancer at the age of 35 and below, and to analyze the prognostic factors. Methods The clinical data of 89 cases of young breast cancer patients (≤35 years old) treated in Taihe Hospital of Shiyan City, Hubei Province from February 2007 to January 2014 were retrospectively analyzed, and the clinicopathological characteristics and prognostic factors were analyzed. Results There were 86 cases of surgical treatment and 3 cases of salvage treatment in young breast cancer patients. Surgery in patients with Luminal A type 21 cases, 16 cases of Luminal B type, HER-2 overexpression was found in 11 cases, triple negative breast cancer 38 cases, invasive ductal carcinoma in 73 cases, clinical staging Ⅱ period 54.6% and Ⅲ period was 24.4%. There was no significant difference in tumor size, clinical stage, Ki67, lymph node metastasis and other indicators in different molecalar types (P ＞ 0.05). There was no statistically significant difference in recurrence, metastasis and survival rate between 3 and 5 years of follow-up (P ＞ 0.05). Tumor size, lymph node metastasis, Ki67, age and clinical stage were the main factors influencing the prognosis of young breast cancer (P ＜ 0.05). Lymph node metastasis, tumor size and clinical stage were independent risk factors for prognosis (P ＜ 0.05). Conclusions The majority of young breast cancer patients are triple negative, and the clinical stage is late. Tumor size and lymph node metastasis have a great influence on the prognosis, so early diagnosis and early treatment are needed to improve the prognosis. However, the effect of molecular typing on the prognosis needs to be further studied.

Key words： Breast cancer Young Molecular types Prognosis

基金资助:湖北省十堰市科学技术研究与开发项目（17Y17）。

通讯作者: 王群（1976-），男，硕士，副主任医师，副教授，硕士生导师，主要从事乳腺甲状腺疾病临床研究。

作者简介: 艾勇彪（1985-），男，硕士，主要从事乳腺甲状腺疾病临床研究。

引用本文:

艾勇彪袁杰李文仿王群. 不同分子分型青年乳腺癌的临床特点及预后因素分析[J]. 中国医药导报, 2020, 17(8): 117-120.
AI Yongbiao YUAN Jie LI Wenfang WANG Qun. Analysis of clinical characteristics and prognostic factors of different molecular types of young breast cancer. 中国医药导报, 2020, 17(8): 117-120.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I8/117

[1] Qiu J，Xue X，Hu C，et al. Comparison of Clinicopathological Features and Prognosis in Triple-Negative and Non-Triple Negative Breast Cancer [J]. J Cancer，2016，7（2）：167-173.
[2] Rapiti E，Pinaud K，Chappuis PO，et al. Opportunities for improving triple-negative breast cancer outcomes：results of a population-based study [J]. Cancer Med，2017，6（3）：526-536.
[3] 艾勇彪，张丹峰，李文仿，等.青年和老年乳腺癌病理特征及预后差异的分析[J].现代肿瘤医学，2018，26（23）：3764-3767.
[4] 刘裔莎，魏兵，杨雯娟，等.美国癌症联合会乳腺癌分期（第七版）简介[J].中华病理学杂志，2010，39（11）：787-790.
[5] 杨文涛，步宏.乳腺癌雌、孕激素受体免疫组织化学检测指南[J].中华病理学杂志，2015，44（4）：237-239.
[6] 中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范（2015版）[J].中国癌症杂志，2015，25（9）：692-754.
[7] 《乳腺癌HER2检测指南》编写组.乳腺癌HER2检测指南（2014版）[J].中华病理学杂志，2014，43（4）：262-267.
[8] Wang W，Wang X，Liu J，et al. Breast cancer in young women of Chinese Han population：A retrospective study of patients under 25 years [J]. Pathol Res Pract，2016，212（11）：1015-1020.
[9] Fu J，Wu L，Fu W，et al. How young is too young in breast cancer? -Young breast cancer is not a unique biological subtype [J]. Clin Breast Cancer，2018，18（1）：25-39.
[10] Botteri E，Veronesi P，Vila J，et al. Improved prognosis of young patients with breast cancer undergoing breast-conserving surgery [J]. Br J Surg，2017，104（13）：1802-1810.
[11] Lian W，Fu F，Lin Y，et al. The Impact of Young Age for Prognosis by Subtype in Women with Early Breast Cancer [J]. Sci Rep，2017，7（1）：11625.
[12] Alissar EC，Raafat A，Ayman H，et al. Younger age is an independent predictor of worse prognosis among Lebanese nonmetastatic breast cancer patients：analysis of a prospective cohort [J]. Breast Cancer，2017，9（10）：407-414.
[13] Ellsworth RE，Blackburn HL，Shriver CD，et al. Molecular heterogeneity in breast cancer：State of the science and implications for patient care [J]. Semin Cell Dev Biol，2017，64（1）：65-72.
[14] Roulot A，Héquet D，Guinebretière JM，et al. Tumoral heterogeneity of breast cancer [J]. Ann Biol Clin，2016， 74（6）：653-660.
[15] Esparza-López J，Escobar-Arriaga E，Soto-Germes S，et al. Breast Cancer Intra-Tumor Heterogeneity：One Tumor，Different Entities [J]. Rev Invest Clin，2017，69（2）：66-76.
[16] Munoz DF，Plevritis SK. Estimating Breast Cancer Survival by Molecular Subtype in the Absence of Screening and Adjuvant Treatment [J]. Med Decis Making，2018，38（1）：32-43.
[17] Plevritis SK，Munoz D，Kurian AW，et al. Association of Screening and Treatment With Breast Cancer Mortality by Molecular Subtype in US Women，2000-2012 [J]. JAMA，2018，319（2）：154-164.
[18] Alabdulkareem H，Pinchinat T，Khan S，et al. The impact of molecular subtype on breast cancer recurrence in young women treated with contemporary adjuvant therapy [J]. Breast J，2018，24（2）：148-153.
[19] Adriana-Andreea J，Maria CA，Domenico R，et al. Triple negative breast cancer：the kiss of death [J]. Oncotarget，2017，8（28）：46652-46662.
[20] Maishman T，Cutress RI，Hernandez A，et al. Local Recurrence and Breast Oncological Surgery in Young Women With Breast Cancer [J]. Ann Surg，2017，266（1）：165-172.
[21] 宋美英，王玲，张财家，等.对比分析青年及中老年乳腺癌患者临床病理特征及免疫组化特点[J].当代医学，2019，25（28）：80-82.
[22] Ellegaard MBB，Grau C，Zachariae R，et al. Fear of cancer recurrence and unmet needs among breast cancer survivors in the first five years. A cross-sectional study [J]. Acta Oncol，2017，56（2）：314-320.
[23] Liedtke C，Rody A，Gluz O，Baumann K，et al. The prognostic impact of age in different molecular subtypes of breast cancer [J]. Breast Cancer Res Treat，2015，152（3）：667-673.
[24] Gregorio DI，Ford C，Samociuk H. Geography of breast cancer incidence according to age & birth cohorts [J]. Spat Spatiotemporal Epidemiol，2017，21（3）：47-55.
[25] Wen D，Wen X，Yang Y，et al. Urban rural disparity in female breast cancer incidence rate in China and the increasing trend in parallel with socioeconomic development and urbanization in a rural setting [J]. Thorac Cancer，2018，9（2）：262-272.
[26] 韦玉亚，姜伟，朱婷，等.X线和彩色多普勒超声成像在早期乳腺癌诊断中的价值[J].中国医药科学，2019，9（13）：160-163.