Pinto António E, Matos João, Pereira Teresa, Silva Giovani L, André Saudade
Department of Pathology, Portuguese Institute of Oncology of Lisbon, 1099-023 Lisbon, Portugal.
Department of Mathematics, Higher Technical Institute, University of Lisbon, 1049-001 Lisbon, Portugal.
Oncol Lett. 2022 Aug 4;24(4):329. doi: 10.3892/ol.2022.13449. eCollection 2022 Oct.
The influence of age on the outcome of patients with invasive breast carcinoma (IBC) has not yet been fully established. The present study investigated two subgroups of patients either side of the age spectrum, and evaluated cytometric, histopathological and molecular characteristics. The series involved 219 patients with IBC that had long-term follow-up, which were divided into two subgroups: Young (≤45 years; n=103) and old patients (≥75 years; n=116). Immunohistochemical evaluation of hormonal receptors, Ki67 index and HER2 status (plus HER2 silver hybridization in equivocal cases) were used as the basis for surrogate molecular subtyping. Ploidy and S-phase fraction (SPF) were analysed by DNA flow cytometry. Differences between the subgroups' characteristics were assessed by the two proportion Z test. Kaplan-Meier estimation and log-rank test were applied for survival analyses. The median age in the subgroups were 40 years (range, 19-45 years) in the young group and 78 years (range, 75-91 years) in the older subgroup. Young patients exhibited higher lymph node involvement, more advanced disease staging, higher SPF tumour proliferative activity, and a trend of lower incidence of Luminal A and higher incidence of Luminal B tumours. The median SPF value was significantly higher in young patients [7.1% (range, 1.5-23.7%) vs. 4.5% (range, 0.7-26.4%)], whereas the ploidy pattern showed no significant difference. In the whole series, as within IBC of no special type, young patients had a higher rate of recurrence (46.6 vs. 22.4%; P<0.001) and deaths from disease (35.9 vs. 20.7%; P=0.030), with a statistically significant difference for disease-free survival. In conclusion, the present study indicated that young patients with IBC exhibited more aggressive disease, with an increased risk of recurrence and shorter disease-free survival. SPF, lymph node status and staging appeared to be the main prognostic factors to differentiate young from older patients with IBC.
年龄对浸润性乳腺癌（IBC）患者预后的影响尚未完全明确。本研究调查了年龄范围两端的两个患者亚组，并评估了细胞计量学、组织病理学和分子特征。该系列研究纳入了219例接受长期随访的IBC患者，分为两个亚组：年轻患者（≤45岁；n = 103）和老年患者（≥75岁；n = 116）。激素受体的免疫组化评估、Ki67指数和HER2状态（在可疑病例中加做HER2银染杂交）被用作替代分子分型的基础。通过DNA流式细胞术分析倍体和S期分数（SPF）。亚组特征之间的差异通过两比例Z检验进行评估。采用Kaplan-Meier估计法和对数秩检验进行生存分析。年轻组亚组的中位年龄为40岁（范围19 - 45岁），老年亚组为78岁（范围75 - 91岁）。年轻患者表现出更高的淋巴结受累率、更晚期的疾病分期、更高的SPF肿瘤增殖活性，以及Luminal A肿瘤发生率较低和Luminal B肿瘤发生率较高的趋势。年轻患者的中位SPF值显著更高[7.1%（范围1.5 - 23.7%）对4.5%（范围0.7 - 26.4%）]，而倍体模式无显著差异。在整个系列中，与非特殊类型的IBC一样，年轻患者的复发率更高（46.6对22.4%；P < 0.001），疾病死亡率更高（35.9对20.7%；P = 0.030），无病生存期有统计学显著差异。总之，本研究表明，IBC年轻患者表现出更具侵袭性的疾病，复发风险增加，无病生存期更短。SPF、淋巴结状态和分期似乎是区分IBC年轻患者和老年患者的主要预后因素。
