| Objective:To analyze the clinicopathological characteristics and molecular biological indicators of patients with early invasive breast cancer in three different age groups,and to explore the relationship between age and clinicopathological characteristics and molecular biological indicators,so as to enhance the understanding of breast cancer in different age groups and guide clinical diagnosis and treatment,improve the prognosis of patients and achieve long-term survival.Methods:The clinicopathological data and molecular biological indicators of patients who were diagnosed with breast cancer in the Second Hospital of Jilin University from August 2016 to August 2019 were collected and analyzed.The collected patients with breast cancer were divided into 3 groups according to their age:(1)the young group:with age less than 40 years old;(2)the middle-aged group: with age ranged from 41 to 59 years old;(3)the elderly group: with age more than 60 years old.Clinicopathological data and molecular biological indicators to be collected include:pathological type,primary tumor(T),regional lymph nodes(N),TNM staging,histological grade(G),Estrogen Receptor(ER),Progesterone Receptor(PR),Human Epidermal Growth Factor Receptor-2(HER-2),Ki-67 level,with or without vascular infiltration,molecular typing,etc.The SPSS 25.0 statistical software was used for statistical processing to compare and analyze the clinicopathological characteristics and molecular biological indicators of the breast cancer patients in each group,and analyze the correlation between age and these indicators.Results:Among the 363 patients with early invasive breast cancer,56 cases were in the young group(56/363,15.43%),248 cases were in the middle-aged group(248/363,68.32%),,and 59 cases were in the elderly group(59/363,16.25%).In terms of tumor size: 254 cases with T≤2cm(254/363,69.97%),106 cases with 2cm <T≤5cm(106/363,29.20%),3 cases with T> 5cm(3/363,0.83%);lymph node metastasis: 111 cases were positive(111/363,30.58%),252 cases were negative(252/363,69.42%);TNM staging:192 cases were in stage I(192/363,52.89%),142 cases were in stage Ⅱ(142/363,39.12%),29 cases were in stage Ⅲ(29/363,7.99%);Histological grading: 7 cases were in grade Ⅰ(7/363,1.93%),285 cases were in grade Ⅱ(285/363,78.51%);71 cases were in grade Ⅲ(71/363,19.56%);the invasion of vascular tumor thrombus: 112 cases with infiltration(112/363,30.85%),251 cases without infiltration(251/363,69.15%);ER: 289 cases were positive(289/363,79.61%),74 cases were negative(74/363,20.39%);PR: 285 cases were positive(285/363,78.51%),78 cases were negative(78/363,21.49%);HER-2: 79 cases were positive(79/363,21.76%),284 cases were negative(284/363,78.24%);Ki-67: 190 cases with high expression of Ki-67(190/363,52.34%),173 cases with low expression of Ki-67(173/363,47.66%);Molecular typing of breast cancer: 34 cases were Luminal A type(34/363,9.37%),57 cases were Luminal B type(HER-2 positive)(57/363,15.70%),204 cases were Luminal B type(HER-2 negative)(204/363,56.20%),46 cases were triple negative breast cancer(46/363,12.67%),and 22 cases had overexpression of HER-2(22/363,6.06%).The SPSS 25.0 statistical software was used for statistical processing.The clinicopathological characteristics and molecular biological indicators of breast cancer patients in each group were compared and analyzed,and the correlation between age and these indicators was analyzed.Results showed that There were statistically significant differences in lymph node metastasis,TNM staging,histological grading and vascular tumor thrombus infiltration among patients in the three age groups,with P of 0.045,0.000,0.037,0.048 and χ2 of 6.192,21.899,10.221,6.062,respectively.There was no statistically significant difference in tumor size among patients in thethree age groups(P> 0.05).Among them,the patients in the young group had higher positive rate of lymph node metastasis of breast cancer(the positive rate of lymph node metastasis of patients in the young group,middle-aged group,and elderly groups was 44.64%,27.82%,28.81%,respectively),had later TNM staging(the proportion of patients in stage Ⅲ in the young group,middle-aged group,and elderly groups was23.22%,5.64%,3.39%,respectively),had higher histological grading(the proportion of patients in stage Ⅲ in the young group,middle-aged group,and elderly groups was33.93%,16.53%,18.64%,respectively),and had higher rate of vascular tumor thrombus infiltration(the patients with vascular tumor thrombus infiltration in the young group,middle-aged group,and elderly groups was accounted for44.64%,27.82%,30.51%,respectively).In molecular biological indicators,there were differences in estrogen receptor(ER),progesterone receptor(PR),Ki-67 expression and molecular typing among patients in the three age groups,and the differences were statistically significant,P was 0.021,0.018,0.000,0.004 and χ2 was7.747,8.035,15.288,22.278,respectively.There was no significant difference in the expression of human epidermal growth factor receptor-2(HER-2)(P> 0.05).Among them,the high expression rate of Ki-67 in patients of the young group(75%)was much higher than that of the middle-aged group(50%)and the elderly group(40.68%).The ER and PR positive rates in the patients of the young group were lower than those in the middle-aged group and the elderly group(the ER positive rates in patients of the young group,middle-aged group,and elderly groups were66.07%,82.66%,79.66%,respectively;and the PR positive rates were64.29%,81.45%,79.66%,respectively).The proportion of patients with Luminal A type in young group was less than that of the middle-aged group and elderly groups(1.79%,9.27% and 16.95% in the young group,middle-aged group and elderly group,respectively),while the proportion of patients with HER-2 overexpression in the young group was more than that of the middle-aged group and elderly group(8.93%,5.24% and 6.78% in the young group,middle-aged group and elderly group,respectively).Conclusions:1.In terms of clinicopathological data,compared with the middle-aged and elderly groups,the patients in the young group had the characteristics of high histological grade,late TNM stage,higher positive rate of lymph node metastasis,and higher invasion rate of vascular cancer thrombus.2.In terms of molecular biological indicators,the ER-positive expression rate,PR-positive expression rate,and proportion of Luminal A type of patients with breast cancer in the young group were lower than those in the middle-aged and elderly groups,while Ki-67 high expression rate in patients of the young group was lower than that of the middle-aged and elderly groups.3.In terms of molecular typing,Luminal B type was dominant in patients of three different age groups.4.Compared with patients in the middle-aged and elderly groups,the patients with breast cancer in the young group has unique clinicopathological characteristics and molecular biological indicators,suggesting that the young patients had high degree of malignancy,poor biological behavior,strong invasion and poor prognosis. |
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