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目的探讨老年乳腺癌不同分子亚型的临床特点及其预后情况。方法回顾性分析手术治疗的原发性乳腺癌172例老年乳腺癌患者临床,根据雌激素受体(ER)、孕激素受体(PR)及人类表皮生长因子受体2(HER-2)的免疫组织化学结果,将172例老年乳腺癌分为5种分子亚型:luminal A型[ER(+)和/或PR(+)且HER-2(-)]l、uminal B型[ER(+)和/或PR(+)且HER-2(+)]、HER-2过表达型[ER(-)、PR(-)且HER-2(+)]、三阴性[ER(-)、PR(-)且HER-2(-)]和未知分型,分析不同亚型的临床特点及预后情况。结果 luminal A型l、uminal B型、HER-2过表达型、三阴性和未知分型所占的比例分别为65.7%、7.6%、14.0%、7.6%和5.1%。肿瘤>2 cm及组织学分级III的乳腺癌在三阴性中的比例明显大于其他类型(P<0.05)。170例中位随访时间48个月,结果显示,HER-2过表达型和三阴性乳腺癌的远处转移率均高于luminal A型(P<0.05)。多因素分析显示肿瘤大小和脉管浸润情况为老年乳腺癌的独立预后因素。结论老年乳腺癌分子分型对患者预后的判断具有重要临床意义,可以为老年乳腺癌患者的个性化治疗提供重要依据。
Objective To investigate the clinical features and prognosis of different molecular subtypes in elderly patients with breast cancer. Methods A retrospective analysis of 172 patients with primary breast cancer undergoing primary surgical treatment of breast cancer was retrospectively performed. According to the clinical data of ER, PR and HER-2 Immunohistochemical results of 172 elderly breast cancers were divided into five molecular subtypes: luminal type A [ER (+) and / or PR (+) and HER-2 (- (-) and HER-2 (+)], HER-2 overexpression [ER , PR (-) and HER-2 (-)] and unknown type, the clinical features and prognosis of different subtypes were analyzed. Results The proportions of luminal A type 1, uminal B type, HER-2 overexpression type, triple negative type and unknown type were 65.7%, 7.6%, 14.0%, 7.6% and 5.1% respectively. The proportion of breast cancer with tumor> 2 cm and histological grade III in triple negative was significantly higher than other types (P <0.05). The median follow-up time of 170 patients was 48 months. The results showed that the distant metastasis rate of HER-2 overexpression and triple negative breast cancer were higher than that of luminal A (P <0.05). Multivariate analysis showed that tumor size and vascular invasion were independent prognostic factors in elderly patients with breast cancer. Conclusion The molecular classification of the elderly breast cancer has important clinical significance in judging the prognosis of patients and may provide an important basis for the personalized treatment of elderly patients with breast cancer.