3846例乳腺癌流行病学及临床病理学分析

Epidemiological and clinicopathological characteristics of patients with breast cancer: A retrospective analysis of 3 846 case

  • 摘要: 目的 分析乳腺癌患者的流行病学特点、临床病理特征、手术方式及辅助治疗情况,并对中国人群、亚洲人群及欧美人群进行比较。 方法 收集2000年1月- 2012年12月我院收治的全部乳腺癌患者资料,建立乳腺癌诊疗信息数据库,分析其基本情况、病理特征、临床特征、分子学特征、手术与辅助治疗情况的总体分布及其随年代的变化趋势。 结果 3 846例Ⅰ~Ⅳ期乳腺癌患者主要来自中国北方各省市,中位确诊年龄为48(18 ~ 91)岁,发病年龄高峰出现在41 ~ 50岁。绝经前患者占59.18%;浸润性导管癌占78.13%;组织学Ⅰ、Ⅱ级占66.84%;激素受体(hormone receptor,HR)阳性率为73.78%,Her-2受体阳性率为20.72%;分子亚型Luminal B型占49.48%,Luminal A型占23.66%,三阴型乳腺癌13.02%;根据St.Gallen标准,低、中危患者占75.62%;Ⅰ~Ⅱ期患者占78.01%。确诊为Ⅰ期乳腺癌、原位癌与微小肿瘤的比例逐年升高,Ⅱ期、Ⅲ~Ⅳ期乳腺癌呈下降趋势。改良根治术是本组乳腺癌的主要术式,保乳率及前哨淋巴结活检率自2000年以后逐年升高,手术范围趋于缩小化,乳腺癌辅助治疗方案的选择随年代而变化。 结论 本组发病年龄、月经及受体状态等分布与欧美人群有较大差异。随时间的推移,早期乳腺癌及微小肿瘤比例逐渐升高,手术范围逐渐缩小,辅助治疗趋于规范。

     

    Abstract: Objective To summarize the epidemiological and clinicopathological characteristics of patients with breast cancer treated in Chinese PLA General Hospital, and compare these features with paitents in China, Asian and western countries. Methods Clinical data about patients with breast cancer in our hospital from January 2000 to December 2012 were collected. The distribution of epidemiological and pathological features of these patients was described and analyzed. Results A total of 3 846 cases with breast cancer in stageⅠto stageⅣ, who mainly came from the north area of China, were included. The median age was 48 years (ranged from 18 to 91 years), with the peak in 41-50 years. Premenopausal women accounted for 59.18%. The major pathological type was invasive ductal carcinoma (78.13%). Scarff-Bloom-Richardson (SBR) gradeⅠ-Ⅱaccounted for 66.84%. The positive rate of hormone receptor and HER-2 receptor was 73.78% and 20.72%, respectively. Molecular subtype of Luminal B accounted for 49.48% followed by Luminal A (23.66%), and triple negative breast cancer accounted for 13.02%. According to the St. Gallen Consensus, 75.62% of patients were at low or intermediate risk, and patients in clinical stageⅠ-Ⅱaccounted for 78.01%. During the last decade, the proportion of patients in stageⅠ, and patients with DCIS/LCIS and small tumor (T1) increased gradually, while fewer patients were diagnosed with stageⅡand stageⅢ-Ⅳ. Modified radical mastectomy was the main surgery method in our hospital, with an upward trend of conservative surgery and sentinel lymph node biopsy (SLNB) since 2000. The operative region tended to be smaller, and adjuvant chemotherapy in our hospital changed with time. Conclusion Epidemiological and clinicopathological characteristics of breast cancer in recent ten years in Chinese PLA General Hospital is reported in this article, which is similar to that of China and other Asian countries, but different with Western countries in many aspects (eg. the mean age of onset, the distribution of menstruation and receptor status). As time goes by, patients diagnosed with early breast cancer and small tumor increase gradually, the operative region is narrowed, and adjuvant chemotherapy in our hospital changes with time as guidelines updated.

     

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