CAJ | 학술논문

背景与目的:西方国家年轻乳腺癌发病率较低,年龄<35岁是影响乳腺癌预后的因素之一.本研究比较华南地区年轻乳腺癌(年龄<35岁)和非年轻绝经前(年龄≥35岁)患者的临床病理特征和预后,初步探讨影响年轻乳腺癌的预后因素.方法:收集2003年10月至2006年12月中山大学肿瘤防治中心收治的905例绝经前可手术乳腺癌患者的临床资料,其中年龄<35岁的年轻患者189例(研究组),≥35岁者716例(对照组),回顾性分析年轻乳腺癌患者的临床病理特征及复发情况.结果:全组患者中位随访时间为27.77个月.研究组3年无病生存率(disease-free survival,DFS)为78.0%,对照组3年DFS为89.1%,两组间差异有统计学意义(P<0.001).研究组3年总生存(overall survival,OS)率为94.3%,对照组3年OS率为96.8%,两组间差异无统计学意义(P=0.10).研究组和对照组ER或PR阴性患者的DFS与OS差异无统计学意义(P>0.05);研究组中ER或PR阳性患者的DFS与OS均差于对照组(P<0.05).单因素分析和多因素分析表明,年龄<35岁、淋巴结转移、脉管癌栓以及Ki67高表达均为复发高危因素.结论:<35岁的HR阳性者年轻乳腺癌患者预后较≥35岁绝经前患者差.
배경여목적:서방국가년경유선암발병솔교저,년령<35세시영향유선암예후적인소지일.본연구비교화남지구년경유선암(년령<35세)화비년경절경전(년령≥35세)환자적림상병리특정화예후,초보탐토영향년경유선암적예후인소.방법:수집2003년10월지2006년12월중산대학종류방치중심수치적905례절경전가수술유선암환자적림상자료,기중년령<35세적년경환자189례(연구조),≥35세자716례(대조조),회고성분석년경유선암환자적림상병리특정급복발정황.결과:전조환자중위수방시간위27.77개월.연구조3년무병생존솔(disease-free survival,DFS)위78.0%,대조조3년DFS위89.1%,량조간차이유통계학의의(P<0.001).연구조3년총생존(overall survival,OS)솔위94.3%,대조조3년OS솔위96.8%,량조간차이무통계학의의(P=0.10).연구조화대조조ER혹PR음성환자적DFS여OS차이무통계학의의(P>0.05);연구조중ER혹PR양성환자적DFS여OS균차우대조조(P<0.05).단인소분석화다인소분석표명,년령<35세、림파결전이、맥관암전이급Ki67고표체균위복발고위인소.결론:<35세적HR양성자년경유선암환자예후교≥35세절경전환자차.
Background and Objective: Even though most breast cancers occur in postmenopausal women in western countries,age<35 is one of the prognostic factors.This study was to compare the clinicopathologic characte ristics and prognosis between premenopausal breast cancer patients aged of<35 and≥35 in south China.and to explore the prognostic factors.Methods:A total of 905 consecutive premenopausal patients were evaluated,with first diagnosis of breast cancer referred to surgery at the Sun Yat-sen University Cancer Center from October 2003 to December 2006.The clinicopathologic factors and the survival rates between the very young group (aged of<35 at diagnosis) and the non-young group(aged of≥35 at diagnosis) were retrospectively compared. Results:The overall median follow-up time was 27.77 months.The 3-year disease-free survival rate was significantly lower(78.0%VS.89.1%,P<0.001)and the 3-year survival rate relatively lower(94.3%vs.96.8%,P=0.10)in the very young group than in the non-young group. In addition,the 3-year survival and disease-free survival rates were significantly lower in the very young group with HR (hormone receptor)-positive than in the non-young group(P<0.05).The univariate and multivariate analysis of clinicopathologic characteristics between two groups showed that age<35 at diagnosis,axillary lymph node involvement,presence of vascular invasion, and high expression of Ki67 were risk factors for recurrence. Conclusion: Compared with non-young premenopausal patients,very young breast patients with HR-positive cancer have a worse outcome.