万颜凯 张世豪 花秀英

【摘要】 目的：探討和分析不同年龄范围界定下的老年乳腺癌患者的临床病理特征。方法：回顾分析性2010年1月-2020年1月于东莞市企石医院和东莞市人民医院诊治年龄≥65岁且有明确病理诊断的118例原发性乳腺癌患者的临床资料，以70岁为界，分为65～70岁组（n=64）和>70岁组（n=54），比较两组临床病理特征间的差异，包括组织类型、肿瘤大小、腋窝淋巴结转移、脉管浸润、组织学分化、TNM分期、雌激素受体（ER）表达、孕激素受体（PR）表达、Ki-67表达及分子分型，并对两组患者进行随访，比较65～70岁组和>70岁组的浸润性导管癌患者的3年无病生存率（DFSR）。结果：65～70岁组和>70岁组组织类型、肿瘤大小、有无腋窝淋巴结转移、有无脉管浸润、组织学分化、TNM分期、ER表达、PR表达、Ki-67表达及分子分型比较，差异均无统计学意义（P>0.05）。采用Kaplan-Meier法对83例浸润性导管癌患者的DFS进行分析，结果显示65～70岁组和>70岁组的浸润性导管癌患者的3年DFSR分别为85.68%、89.24%，差异无统计学意义（P>0.05）。结论：65～70岁和>70岁的老年乳腺癌患者的临床病理特征及预后具有相似性，这两个年龄范围的老年乳腺癌患者临床治疗不应受高龄的限制，而应综合评估其身体机能状况而制定积极有效治疗方案。

【关键词】 老年 乳腺癌 临床病理特征 无病生存期

Analysis of Clinicopathological Characteristics of Elderly Patients with Breast Cancer Defined by Different Age Ranges/WAN Yankai， ZHANG Shihao， HUA Xiuying. //Medical Innovation of China， 2021， 18（12）： -174

[Abstract] Objective： To investigate and analyze the clinicopathological characteristics of elderly patients with breast cancer defined by different age ranges. Method： From January 2010 to January 2020， 118 patients with primary breast cancer aged over 65 years old and with definite pathological diagnosis were retrospectively analyzed. Taking 70 years old as the boundary， they were divided into 65-70 years old group （n=64） and >70 years old group （n=54）. The differences of clinicopathological characteristics between the two groups were compared， including tissue type， tumor size， axillary lymph node metastasis， vascular invasion， histological differentiation， TNM stage， estrogen receptor （ER） expression， progesterone receptor （PR） expression， Ki-67 expression and molecular classification were followed up. The 3-year disease-free survival rates （DFSR） between 65-70 years old group and >70 years old groups patients with invasive ductal carcinoma were compared. Result： There were no significant differences in tissue type， tumor size， axillary lymph node metastasis， vascular invasion， histological differentiation， TNM stage， ER expression， PR expression， Ki-67 expression and molecular classification between two groups （P>0.05）. Kaplan-Meier method was used to analyze the DFS of 83 patients with invasive ductal carcinoma， the results showed that the 3-year DFSR of 65-70 years old group and >70 years old group patients with invasive ductal carcinoma were 85.68% and 89.24%， respectively， and the difference was not statistically significant （P>0.05）. Conclusion： The clinicopathological features and prognosis of elderly breast cancer patients aged 65-70 years and >70 years are similar. The clinical treatment of these two age groups of elderly breast cancer patients should not be limited by advanced age， but should be comprehensively evaluated to develop active and effective treatment programs.

[Key words] Elderly Breast cancer Clinicopathological features Disease-free survival

First-authors address： Dongguan Qishi Hospital， Dongguan 523500， China

doi：10.3969/j.issn.1674-4985.2021.12.041

乳腺癌是女性最为常见的恶性肿瘤之一。随着社会不断进步，人类寿命不断延长，我国65岁以上老年人乳腺癌发病率呈逐年上升趋势，预计到2030年，65岁以上乳腺癌患者发病率预计达27%[1-3]。老年乳腺癌患者常伴有基础病或其他系统疾病，对手术和放化疗耐受性差[4-5]。国内多数文献常将≥65岁