论文部分内容阅读
目的:分析70岁以上女性乳腺癌患者的临床病理特征、治疗方式及预后影响因素。方法:回顾2007年1月—2010年12月哈尔滨医科大学附属肿瘤医院乳腺外科接诊并接受手术治疗的203例70岁以上老年女性乳腺癌患者的临床资料,分析其临床病理特点及生存情况。结果:203例患者中,临床TNMⅠ期患者67例(33.0%),Ⅱ期患者117例(57.6%);无腋窝淋巴结转移患者92例(53.5%);浸润性导管癌166例(81.8%),为主要病理类型;177例行免疫组织化学检查,ER、PR阳性与HER-2过表达患者分别为123例(69.5%)、114例(64.4%)、23例(13.0%);乳腺癌改良根治术153例(75.4%),为主要手术方式;术后接受内分泌治疗患者111例(54.7%),化疗患者28例(13.8%)。单因素分析显示年龄、淋巴结状态、ER、PR、组织学分级与内分泌治疗与患者总生存时间(OS)有关,淋巴结状态、ER、PR、HER-2、内分泌治疗与化疗与患者无病生存时间(DFS)有关(均P<0.05);COX多因素分析显示年龄、淋巴结状态和PR为OS的独立影响因素,淋巴结状态为DFS的独立影响因素(均P<0.05)。结论:老年女性乳腺癌具有独特生物学特性,主要治疗方式为手术治疗。年龄、淋巴结状态和PR是老年女性乳腺癌的独立预后因素。
OBJECTIVE: To analyze the clinicopathological characteristics, treatment modalities and prognostic factors of breast cancer patients over 70 years of age. Methods: The clinical data of 203 elderly women aged over 70 years with breast cancer admitted to Department of Breast Surgery, Affiliated Tumor Hospital, Harbin Medical University from January 2007 to December 2010 were retrospectively reviewed. The clinicopathological characteristics and survival were analyzed. Results: Of the 203 patients, 67 (33.0%) were in clinical TNM stage I, 117 (57.6%) in stage II, 92 (53.5%) were without axillary lymph node metastasis, and 166 (81.8% (69.5%), 114 (64.4%) and 23 (13.0%) patients with ER, PR positive and HER-2 overexpression, respectively. Of the 177 patients with immunohistochemical staining, breast cancer 153 cases (75.4%) were treated by modified radical mastectomy, which were the main surgical methods. 111 cases (54.7%) received endocrine therapy and 28 cases (13.8%) received chemotherapy. Univariate analysis showed that age, lymph node status, ER, PR, histological grade and endocrine therapy were related to overall patient survival time (OS), lymph node status, ER, PR, HER-2, endocrine therapy and chemotherapy, (P <0.05). Cox multivariate analysis showed that age, lymph node status and PR were the independent influential factors of OS. The status of lymph nodes was the independent influential factor of DFS (all P <0.05). Conclusion: Breast cancer in elderly women has unique biological characteristics, the main treatment for surgical treatment. Age, lymph node status and PR are independent prognostic factors for elderly women with breast cancer.