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目的 :分析小于35岁进展期乳腺癌患者的分子类型和转移特征,并探讨影响预后的因素。方法 :回顾性分析2011年1月至2016年1月在北京大学肿瘤医院就诊的发病年龄小于35岁的153例进展期乳腺癌患者,对其预后相关因素进行单因素和多因素分析。结果 :本组患者中位发病年龄为31.7岁,中位无病生存期为28.4个月。153例患者中,有直系肿瘤家族史24例(15.7%),初治Ⅳ期11例(7.2%);首发转移部位以骨转移最常见,为63例(41.2%)。随访至2016年4月,中位生存期为31.3个月,5年生存率为18.1%。多因素分析结果显示,直系肿瘤家族史、雌激素受体阴性、孕激素受体阴性、肿瘤体积较大是独立的不良预后因素(P值均<0.05)。结论 :进展期年轻乳腺癌受年龄因素影响,预后明显变差。肿瘤较大、激素受体阴性和肿瘤直系家族史是其独立的不良预后因素。
OBJECTIVE: To analyze the molecular types and metastatic characteristics of patients with advanced breast cancer less than 35 years old and to explore the factors that influence the prognosis. Methods: A retrospective analysis of 153 patients with advanced breast cancer who were less than 35 years of age at Peking University Cancer Hospital from January 2011 to January 2016 was performed. Univariate and multivariate analyzes were performed on the prognostic factors. Results: The median age of onset was 31.7 years and the median disease-free survival was 28.4 months. Among 153 patients, there were 24 cases (15.7%) with family history of direct tumor and 11 cases (7.2%) with newly diagnosed stage Ⅳ. The bone metastasis was the most common in 63 cases (41.2%). Followed up to April 2016, the median survival was 31.3 months, 5-year survival rate was 18.1%. Multivariate analysis showed that family history of orthopedic cancer, negative estrogen receptor, negative progesterone receptor, and large tumor volume were independent adverse prognostic factors (all P <0.05). Conclusions: Prognosis is significantly worsened by age-related factors in advanced breast cancer. Larger tumors, hormone receptor-negative, and family history of tumors are their independent, poor prognostic factors.