摘要
目的 分析老年女性乳腺癌患者临床及病理特点,以期为老年女性乳腺癌患者规范化临床诊断、治疗提供帮助. 方法 回顾性分析2011年1月至12月在北京医院乳腺中心诊断治疗的所有女性乳腺癌患者共178例,分为老年组（≥65岁,78例）和非老年组（＜65岁,100例）,记录患者一般临床特点、影像学诊断、手术方式和病理学诊断；采用SAS 9.1统计软件对两组资料进行分析. 结果 钼靶检查在老年组诊断乳腺影像报告及数据系统（BI-RAD） 4-5类的比例为82.1％,在非老年组为63.0％（P＜0.05）,超声和钼靶检查在老年组诊断准确率差异无统计学意义（P＞0.05）,而非老年组超声诊断准确率高于钼靶检查（P＜0.05）.老年组患者的并发疾病尤其是2种以上并发疾病明显多于非老年组（P＜0.05）；在老年组有14例进行了单纯乳腺切除手术（其中4例行单纯乳腺切除＋前哨淋巴结活检）,非老年组只有3例（P＜0.05）.手术后的病理诊断结果分析发现,2组在雌激素受体、孕激素受体、肿瘤大小、组织学分级、病理分期上均无统计学意义（均P＞0.05）；老年组淋巴结转移较非老年组少（P＜0.05）；Ki-67表达阳性率在老年组较非老年组低（P＜0.05）；CerbB-2（＋＋＋）在非老年组为24.0％,老年组为5.1％,差异有统计学意义（P＜0.05）；2组乳腺癌病理类型均以浸润性导管癌为主,但老年组混合型及其他类型的乳腺癌明显多于非老年组（P＜0.05）. 结论 超声及钼靶对老年女性乳腺癌的诊断均有较好的准确性,可在临床选用；老年人合并疾病较多,制定外科手术方案时经常会受到影响；部分预后指标在老年组和非老年组有差异,提示老年乳腺癌的预后较非老年要好.
Objective To analyze the clinical and pathological characteristics of breast carcinoma in elderly female patients and to offer the standard clinical diagnosis and treatment for breast carcinoma.Methods A total of 178 patients admitted to Breast Center of Beijing Hospital from January to December 2011 were enrolled in this retrospective study.Patients were divided into non-elderly group and elderly group.Clinical features,imaging diagnosis,operation patterns and pathological diagnosis were recorded.The data were analyzed by using SAS 9.1 software.Results The patients diagnosed as breast carcinomas in BI-RAD 4-5 categories by mammography were much more in the elderly group than in the non-elderly group （82.1% vs.63.0%,P〈0.05）.The diagnostic accuracy rates of ultrasonography and mammography in the elderly group were comparable（P〉 0.05）,while in the non-elderly group,the diagnostic accuracy rate of ultrasonography was higher than that of mammography （P〈0.05）.The incidence of concurrent diseases was higher in the elderly group than in the non-elderly group （P〈0.05）.The patients undergoing breast resection operation were much more in the elderly group than in the non-elderly group （14 cases vs.3 cases,P〈0.05）.The pathological diagnosis analysis showed that there were no significant differences in the number of ER-positive cells and PR-positive cells,tumor size,histological grade,pathological stage between the two groups （all P〉0.05）.The incidence of lymph node metastasis was lower in the elderly group than in the non-elderly group （P〈0.05）.The percentage of Ki-67 positive cells was lower in the elderly group than in the non-elderly group （P〈0.05）.The percentage of CerbB-2 strongly positive （＋＋＋） cells was lower in the elderly group than in the non-elderly group （5.1 % vs.24%,P〈0.05）.The invasive ductal carcinoma was the major histological type of breast cancer in both two groups,but there were more mixed type and other type carcinomas in the elderly group
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第5期536-539,共4页
Chinese Journal of Geriatrics
关键词
乳腺肿瘤
病理学
临床
Breast neoplasms
Pathology, clinical
