摘要目的 分析中国年轻乳腺癌的临床病理特征,并探讨年轻乳腺癌患者的预后.方法 回顾分析北京肿瘤医院乳腺中心1994年12月至2003年12月收治的1538例Ⅰ～Ⅲ期可手术原发性乳腺癌患者的临床资料,其中年龄≤60岁且有完整随访资料者1075例.按年龄将1075例患者分为年轻组(≤40岁,208例)和对照组(41～60岁,867例),分析两组患者的预后及临床病理特征之间的差异.结果 与对照组相比,年轻组更倾向于淋巴结转移(P=0.016)、雌激素受体表达阴性(P=0.016)以及人表皮生长因子受体2表达阳性(P=0.001).年轻组和对照组5年无病生存率(DFS)分别为73.3%和84.1%(P<0.001),5年总生存率(OS)分别为83.5%和89.1%(P=0.004).进一步分层分析显示,在Ⅰ～Ⅱ期患者中年轻组预后不良,而在Ⅲ期患者中年轻组预后与对照组差异无统计学意义.在Ⅰ～Ⅱ期患者中,年龄≤40岁是影响DFS(HR=1.78,95%CI:1.19～2.66;P=0.005)和OS(HR=1.71,95%CI:1.01～2.90;P=0.046)的独立不良预后因素.结论 中国年轻乳腺癌患者预后不良,这种不良预后在临床Ⅰ～Ⅱ期乳腺癌患者中更为明显.

abstractsObjective To analyze the clinicopathologic characteristics and evaluate the prognosis in young Chinese women with breast cancer. Methods A total of 1538 female patients with operable primary breast cancer (stage Ⅰ - Ⅲ) treated at our hospital from December 1994 to December 2003 were analyzed retrospectively. Among them, 1075 patients (≤60 yrs) with the complete follow-up data were divided into two groups according to age: young breast cancer group ( ≤40 yrs, n = 208) and control group (41-60 yrs, n = 867) to analyze the differences in their clinicopathologic characteristics and evaluate the prognosis of both groups. Results The patients with young breast cancer were more likely to have positive lymph nodes (P=0.016) , a negative expression of ER (estrogen receptor) (P = 0.016) and a positive expression of HER2 (P = 0. 001). The 5-year disease-free survival (DFS) rates of young breast cancer group and control group were 73. 3% and 84. 1% (P <0. 001) and the 5-year overall survival (OS) rates 83. 5% and 89. 1% (P = 0.004) respectively. Moreover, the patients with young breast cancer had a worse DFS than control group in patients with stage Ⅰ - Ⅱ disease but not in those with stage Ⅲ disease. And ≤40 years was an independent unfavorable prognostic factor of DFS (HR = 1. 78, 95% CI: 1. 19 - 2. 66, P = 0. 005) and OS (HR = 1. 71, 95%CI: 1.01 -2.90, P = 0.046) in the patients with stage Ⅰ - Ⅱ disease. Conclusion Chinese women with young breast cancer have a worse prognosis, particularly in those with stage Ⅰ - Ⅱ disease.