Zhang M L, Wang X, Xing Z Y, Liu J Q, Wang X
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2022 May 23;44(5):425-429. doi: 10.3760/cma.j.cn112152-20200827-00771.
To investigate the clinicopathological factors and prognostic status of young Mammary Paget's disease (MPD) patients with invasive ductal carcinoma (IDC). In this study, we defined the age at diagnosis below 40 years old as young patients, and retrospectively analyzed data from 123 MPD-IDC patients who were admitted at the Cancer Hospital Chinese Academy of Medical Sciences from June 2002 to February 2019. Patients were divided into the young group (≤40 years old, 15 cases) and the old group (>40 years old, 108 cases) according to the age of onset, and the clinicopathological characteristics and prognosis of the two groups were compared. Cox regression model analysis was used to analyze the prognosis influencing factors. The proportions of patients in the young group with non-menopausal, axillary lymph node metastasis, and Ki-67 index ≥15% were 93.3% (14/15), 73.3% (11/15), and 86.7% (13/15), respectively, which were higher than those in the old group [45.4% (49/108), 39.8%(43/108), and 60.2% (65/108), respectively] , with statistically significant differences (<0.05). At an average follow-up of 63.2 months, patients in the young group had a significantly shorter disease-free survival (DFS) compared with that of the old group (=0.012), while the difference in overall survival (OS) between the two groups was not statistically significant (=0.161). Multifactorial Cox regression analysis showed that axillary lymph node status was an independent influencing factor on OS (=3.339, 95% 1.121-9.943) in patients with MPD-IDC, while age was not. Compared with the old group, young patients with MPD-IDC have a higher incidence of axillary lymph node metastasis, high Ki-67 expression, and a shorter DFS, but age is not an independent influencing factor on DFS or OS in patients with MPD-IDC.
探讨年轻乳腺派杰氏病(MPD)合并浸润性导管癌(IDC)患者的临床病理因素及预后情况。在本研究中,我们将诊断时年龄小于40岁的患者定义为年轻患者,并回顾性分析了2002年6月至2019年2月在中国医学科学院肿瘤医院收治的123例MPD-IDC患者的数据。根据发病年龄将患者分为年轻组(≤40岁,15例)和老年组(>40岁,108例),比较两组的临床病理特征及预后。采用Cox回归模型分析预后影响因素。年轻组患者非绝经、腋窝淋巴结转移及Ki-67指数≥15%的比例分别为93.3%(14/15)、73.3%(11/15)和86.7%(13/15),均高于老年组[分别为45.4%(49/108)、39.8%(43/108)和60.2%(65/108)],差异有统计学意义(<0.05)。平均随访63.2个月,年轻组患者的无病生存期(DFS)明显短于老年组(=0.012),而两组总生存期(OS)的差异无统计学意义(=0.161)。多因素Cox回归分析显示,腋窝淋巴结状态是MPD-IDC患者OS的独立影响因素(=3.339,95% 1.121-9.943),而年龄不是。与老年组相比,年轻的MPD-IDC患者腋窝淋巴结转移发生率更高、Ki-67表达高、DFS更短,但年龄不是MPD-IDC患者DFS或OS的独立影响因素。