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| 重庆市1 921例女性乳腺癌住院患者临床流行病学及病理特征回顾性分析 |
| 刘蕴宇1,2,贾新建3,吕亚兰1,谭超1,胡浩2,浦科学1,4* |
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(1. 重庆医科大学医学信息学院卫生信息管理与决策教研室, 重庆 400016;
2. 重庆医科大学附属第二医院病案统计科, 重庆 400010;
3. 德阳市人民医院乳腺外科, 德阳 618000;
4. 重庆医科大学医学数据研究院, 重庆 400016
*通信作者) |
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| 摘要: |
| 目的 分析2010－2019年重庆市6家医院收治的女性原发性乳腺癌住院患者的发病趋势和临床病理学特征。方法 收集重庆医科大学附属第二医院、重庆医科大学附属永川医院、重庆医科大学附属大学城医院、重庆医科大学附属第三医院、重庆东南医院和重庆市铜梁区人民医院6家医院，2010年1月至2019年12月首次确诊并住院治疗的女性原发性乳腺癌患者的临床及病理资料，建立乳腺癌患者临床病理特征数据库。回顾性分析近10年重庆市女性乳腺癌住院患者例数、确诊年龄、病理类型、临床分期、分子分型和手术方式等临床特征及其变化趋势。结果 共入组1 921例女性乳腺癌住院患者，近10年乳腺癌患者确诊人数呈逐年增加趋势，中位年龄为54岁，45～54岁为高发年龄段（784例，40.81%）；绝经后患者有1 276例（66.42%）；病理类型以浸润性导管癌为主（1 387例，72.20%）；确诊时临床分期以0～Ⅱ期为主（1 448例，75.38%）；雌激素受体/孕激素受体阳性者1 304例（67.88%），人类表皮生长因子受体2（HER-2）阳性者699例（36.39%）；分子分型为Luminal B型949例（49.40%），Luminal A型334例（17.39%），三阴性315例（16.40%），HER-2过表达型292例（15.20%）；手术方式以乳腺癌改良根治术为主（1 388例，72.25%）；自2012年后保乳手术率逐渐增加，而前哨淋巴结活检率逐渐降低。多因素logistic回归分析显示，HER-2阳性、三阴性乳腺癌和Ki-67指数>14%是女性乳腺癌住院患者临床分期的危险因素（P均<0.05）。近10年来，女性乳腺癌住院患者的确诊年龄呈下降趋势（P<0.01），HER-2阳性率逐渐提高（P<0.01），而临床分期无显著变化（P>0.05）。结论 2010－2019年重庆市女性乳腺癌住院患者例数呈递增趋势，高发年龄段为45～54岁，确诊年龄呈下降趋势，临床分期以早期为主且随时间的变化趋势不明显，HER-2阳性、三阴性乳腺癌和Ki-67指数>14%是乳腺癌临床分期的危险因素。 |
| 关键词: 乳腺肿瘤 重庆 流行病学 临床病理学 分子病理学 |
| DOI：10.16781/j.0258-879x.2021.06.0617 |
| 投稿时间：2020-09-28修订日期：2020-12-18 |
| 基金项目:重庆市自然科学基金（cstc2019jcyj-msxmX0027）. |
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| Clinical epidemiology and pathological characteristics of 1 921 female breast cancer inpatients in Chongqing, China: a retrospective analysis |
| LIU Yun-yu1,2,JIA Xin-jian3,Lü Ya-lan1,TAN Chao1,HU Hao2,PU Ke-xue1,4* |
(1. Department of Health Information Management and Decision Making, School of Medical Informatics, Chongqing Medical University, Chongqing 400016, China;
2. Department of Medical Records Statistics, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China;
3. Department of Breast Surgery, Deyang People's Hospital, Deyang 618000, Sichuan, China;
4. Medical Data Science Academy, Chongqing Medical University, Chongqing 400016, China
*Corresponding author) |
| Abstract: |
| Objective To analyze the incidence and clinicopathological characteristics of female patients with primary breast cancer admitted to 6 hospitals in Chongqing from 2010 to 2019. Methods The clinical and pathological data of female primary breast cancer patients who were newly diagnosed and hospitalized from Jan. 2010 to Dec. 2019 were collected from 6 hospitals (the Second Affiliated Hospital of Chongqing Medical University, Yongchuan Hospital of Chongqing Medical University, University-Town Hospital of Chongqing Medical University, the Third Affiliated Hospital of Chongqing Medical University, Chongqing Municipal Southeast Hospital, and the People’s Hospital of Tongliang District, Chongqing City), and a database of clinicopathological characteristics of breast cancer patients was established. The clinical characteristics and trends of the female breast cancer inpatients in Chongqing in recent 10 years were analyzed retrospectively, including the number of cases, age of diagnosis, pathological type, clinical stage, molecular subtype and surgery type. Results A total of 1 921 female breast cancer inpatients were enrolled. The number of diagnosed cases increased year by year in recent 10 years. The median age was 54 years old, with the peak in 45-54 years old (784 cases, 40.81%). There were 1 276 (66.42%) postmenopausal patients. The major pathological type was invasive ductal carcinoma (1 387 cases, 72.20%). The clinical stages at the time of diagnosis were mainly at 0-Ⅱ stages (1 448 patients, 75.38%). The positive cases of estrogen and progesterone receptors and human epidermal growth factor receptor 2 (HER-2) were 1 304 (67.88%) and 699 (36.39%), respectively. Molecular subtype of Luminal B accounted for 49.40% (949 cases) followed by Luminal A (17.39%, 334 cases), triple-negative breast cancer (16.40%, 315 cases) and HER-2 overexpression (15.20%, 292 cases). Modified radical mastectomy was the main surgery type (1 388 patients, 72.25%), while the rate of breast conserving surgery was increased gradually and the rate of sentinel lymph node biopsy was decreased gradually since 2012. The multivariate logistic regression analysis showed that HER-2 positive, triple-negative breast cancer and Ki-67 index>14% were risk factors for clinical stage of female breast cancer inpatients (all P<0.05). The trend of the diagnosed age was decreased gradually and the proportion of HER-2 positive was increased gradually in the past 10 years (both P<0.01), while the clinical stage had no significant change (P>0.05). Conclusion The number of female breast cancer patients shows an increasing trend in Chongqing from 2010 to 2019. The peak onset age is 45-49 years old, and the diagnosed age shows a downward trend. The patients with early stage breast cancer account for a large proportion and have no significant change with year. HER-2 positive, triple-negative subtype and Ki-67 index>14% are the risk factors of clinical stage of breast cancer. |
| Key words: breast neoplasms Chongqing epidemiology clinical pathology molecular pathology |
