乳腺癌中受体状态、年龄和分期的相互作用:一项前瞻性分析。

Interplay of Receptor Status, Age, and Stage in Breast Cancer: A Prospective Analysis.

作者信息

Malik Mariam, Mirza Zeeshan R, Idrees Rana Bilal, Nawaz Saba, Arif Jawairia, Ahmad Barira, Chaudry Summaya S, Chaudhary Muhammad Hamid

机构信息

Radiology, Atomic Energy Cancer Hospital, Nuclear Medicine, Oncology and Radiotherapy Institute (NORI), Islamabad, PAK.

Diagnostic Radiology, Institute of Nuclear Medicine and Oncology Lahore (INMOL) Cancer Hospital, Lahore, PAK.

出版信息

Cureus. 2025 Jun 13;17(6):e85925. doi: 10.7759/cureus.85925. eCollection 2025 Jun.

Abstract

Background Breast cancer is the most prevalent cancer among women globally, with significant variations in incidence and characteristics across different age groups and regions. Understanding the relationship between age, hormone receptor status, and breast cancer stage is crucial for developing effective treatment strategies. Objectives This study aimed to: (1) categorize the relationship between receptor status and the stage of breast cancer, (2) determine the frequency of different receptor statuses according to patient age, and (3) correlate the relationship between age and the stage of breast cancer among Pakistani women. Materials and methods A prospective analysis was conducted on 1003 breast cancer patients from a semi-government-run hospital in Lahore, Pakistan, between October 2021 to October 2023 using systematic sampling to recruit every fourth patient of breast cancer. Data on age, tumor grade, histopathological subtype, and hormone receptor status (estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2/NEU (HER2/NEU), Ki-67) were collected and analyzed using SPSS v26 (IBM Corp., Armonk, USA). Chi-squared test was employed to explore associations between age groups and receptor status. Results The mean age of patients was 50.5 years, with a concentration of cases between 41 and 60 years. Invasive ductal carcinoma (IDC) was the most common subtype (91%). Grade II tumors were most prevalent (50.6%), followed by Grade III (45.5%). The majority of patients were ER-positive (62.4%), followed by PR-positive (52.3%), while HER2/NEU positivity was 44%. The most common receptor status was HER2/NEU negative and ER/PR positive (28.9%). Receptor status distribution varied significantly among age groups (p < 0.000), with younger patients more likely to have triple-negative breast cancers and older patients more likely to have ER/PR-positive, HER2/NEU-negative cancers. Ki-67 levels were assessed in 41.5% of patients, with higher levels observed in younger patients. Younger patients (20-30 years) had a higher prevalence of Grade III tumors, whereas older patients (over 60 years) more frequently had Grade II tumors. There were no significant differences in hormone receptor status distribution across cancer stages (p = 0.76). The stage of carcinoma did not significantly differ across age groups (p = 0.05). Conclusion The study highlights significant age-related differences in breast cancer pathology, particularly in tumor grade and receptor status, underscoring the need for age-specific treatment strategies. Younger patients tend to present with more aggressive tumors, necessitating tailored therapeutic approaches to improve outcomes.

摘要

背景

乳腺癌是全球女性中最常见的癌症,不同年龄组和地区的发病率及特征存在显著差异。了解年龄、激素受体状态与乳腺癌分期之间的关系对于制定有效的治疗策略至关重要。

目的

本研究旨在:(1)对受体状态与乳腺癌分期之间的关系进行分类;(2)根据患者年龄确定不同受体状态的频率;(3)关联巴基斯坦女性年龄与乳腺癌分期之间的关系。

材料和方法

2021年10月至2023年10月期间,对巴基斯坦拉合尔一家半政府运营医院的1003例乳腺癌患者进行前瞻性分析,采用系统抽样法招募每第四例乳腺癌患者。收集年龄、肿瘤分级、组织病理学亚型和激素受体状态(雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2/神经(HER2/NEU)、Ki-67)的数据,并使用SPSS v26(美国纽约州阿蒙克市IBM公司)进行分析。采用卡方检验探讨年龄组与受体状态之间的关联。

结果

患者的平均年龄为50.5岁,病例集中在41至60岁之间。浸润性导管癌(IDC)是最常见的亚型(91%)。II级肿瘤最为普遍(50.6%),其次是III级(45.5%)。大多数患者为ER阳性(62.4%),其次是PR阳性(52.3%),而HER2/NEU阳性率为44%。最常见的受体状态是HER2/NEU阴性且ER/PR阳性(28.9%)。受体状态分布在不同年龄组之间存在显著差异(p < 0.000),年轻患者更有可能患三阴性乳腺癌,老年患者更有可能患ER/PR阳性、HER2/NEU阴性的癌症。41.5%的患者评估了Ki-67水平,年轻患者中观察到的水平较高。年轻患者(20 - 30岁)III级肿瘤的患病率较高,而老年患者(60岁以上)II级肿瘤更为常见。激素受体状态分布在癌症各分期之间无显著差异(p = 0.76)。癌分期在不同年龄组之间无显著差异(p = 0.05)。

结论

该研究突出了乳腺癌病理学中与年龄相关的显著差异,特别是在肿瘤分级和受体状态方面,强调了针对不同年龄制定治疗策略的必要性。年轻患者往往表现出更具侵袭性的肿瘤,需要量身定制治疗方法以改善治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a02c/12256065/085ef860eaac/cureus-0017-00000085925-i01.jpg

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