Pronzato P, Mustacchi G, De Matteis A, Di Costanzo F, Rulli E, Floriani I, Cazzaniga M E
Oncologia Medica, IST, Genova 16010, Italy.
Int J Breast Cancer. 2011;2011:534256. doi: 10.4061/2011/534256. Epub 2010 Oct 4.
The present paper described the biological characteristics and clinical behavior of young women in the cohort NORA study
From 2000-2002, patients (N > 3500) were enrolled at 77 Italian hospitals. Women aged ≤50 years (N = 1013) were stratified into age groups (≤35, 36-40, 41-45, and 46-50 years). The relationship between age and patient characteristics, cancer presentation, and treatment was analyzed.
Younger women more frequently had tumors with ER/PgR-negative(χ(2) = 7.07; P = .008), HER2 amplification (χ(2) = 5.76; P = .01), and high (≥10%) Ki67 labelling index (χ(2) = 9.53; P = .002). Positive nodal status, large tumors, and elevated Ki67 all associated with the choice for chemotherapy followed by endocrine therapy in hormone receptor-positive patients (P < .0001). At univariate analysis, ER-ve status, chemotherapy and age resulted as the only statistically significant variables (HR = 2.02, P = .004, and >40 versus ≤40, P < .0001, resp.). At multivariate analysis, after adjustment for significant clinical and pathological factors, age remains a significant prognostic variable (HR = 0.93, P = .0021). CONCLUSION. This cohort study suggests that age per sè is an important prognostic factor. The restricted role of early diagnosis and the aggressive behavior of cancer in this population make necessary the application of targeted medical strategies crucial.
本文描述了NORA队列研究中年轻女性的生物学特征和临床行为。
2000年至2002年期间，超过3500名患者在意大利77家医院入组。年龄≤50岁的女性（n = 1013）被分为不同年龄组（≤35岁、36 - 40岁、41 - 45岁和46 - 50岁）。分析了年龄与患者特征、癌症表现及治疗之间的关系。
年轻女性更常出现雌激素受体/孕激素受体（ER/PgR）阴性肿瘤（χ² = 7.07；P = 0.008）、人表皮生长因子受体2（HER2）扩增（χ² = 5.76；P = 0.01）以及高（≥10%）的Ki67标记指数（χ² = 9.53；P = 0.002）。阳性淋巴结状态、大肿瘤以及升高的Ki67均与激素受体阳性患者选择化疗后内分泌治疗相关（P < 0.0001）。单因素分析中，ER阴性状态、化疗和年龄是仅有的具有统计学意义的变量（风险比[HR] = 2.02，P = 0.004，年龄>40岁与≤40岁相比，P < 0.0001）。多因素分析中，在对显著的临床和病理因素进行校正后，年龄仍然是一个显著的预后变量（HR = 0.93，P = 0.0021）。结论。这项队列研究表明年龄本身是一个重要的预后因素。早期诊断作用有限以及该人群癌症的侵袭性使得应用针对性的医疗策略至关重要。
