Department of Pathology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, China.
Int J Cancer. 2012 Dec 1;131(11):2622-31. doi: 10.1002/ijc.27513. Epub 2012 Apr 17.
In China, breast cancer is currently the most common malignancy and the sixth leading cause of cancer death in women. But, the characteristics of breast cancer in the whole population are not determined. The aim of this study was to perform a detailed study on pathologic characteristics of breast cancer representing the whole population in China during 1999-2008 and to compare the difference in invasive breast cancer between the Western and Chinese. We randomly collected 4,211 inpatient at seven hospitals in representative geographical regions of China during 1999-2008. All the hospitals had the ability of comprehensive cancer treatment. The pathologic characters including estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status were surveyed. The shift of pathologic characters was evaluated and the data from China were also compared with those of the Western, both using Chi-square test. We found as follow. (i) The median age of the patients was 48 years and showed the similar characters of Asia. (ii) Breast cancer in China showed more invasive ductal carcinoma with larger tumor size, later stage, lower ER and PR expression and higher HER2 overexpression than those in the Western (p < 0.001). (iii) Both tumor size and stage at diagnosis decreased year by year (p < 0.001). Breast cancer in China showed more aggressive behavior than those in western countries, although tumor size and stage at diagnosis decreased by year during 1999-2008. We addressed the urgent needs for employ race-specific breast cancer screen, diagnosis methods, and therapeutic models in China.
在中国，乳腺癌是目前最常见的恶性肿瘤，也是女性癌症死亡的第六大主要原因。但是，尚未确定整个人群中乳腺癌的特征。本研究的目的是对 1999-2008 年期间代表中国整个人群的乳腺癌的病理特征进行详细研究，并比较中西方浸润性乳腺癌之间的差异。我们在 1999-2008 年期间，随机从中国具有综合癌症治疗能力的七个代表性地理区域的医院中收集了 4211 例住院患者。所有医院都具有综合癌症治疗能力。调查了病理特征，包括雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体 2（HER2）状态。评估了病理特征的变化，并使用卡方检验比较了中国的数据与西方的数据。我们发现如下结果。（i）患者的中位年龄为 48 岁，具有亚洲相似的特征。（ii）中国的乳腺癌表现为更多的浸润性导管癌，肿瘤较大，分期较晚，ER 和 PR 表达较低，HER2 过表达较高，与西方相比差异有统计学意义（p<0.001）。（iii）诊断时的肿瘤大小和分期均逐年降低（p<0.001）。尽管 1999-2008 年间诊断时的肿瘤大小和分期逐年下降，但中国的乳腺癌表现出比西方国家更具侵袭性的行为。我们迫切需要在中国采用种族特异性的乳腺癌筛查、诊断方法和治疗模式。
