O Martyniuk, I Smolanka, I Smolanka, V Med, T Tarasenko, V Chekhun
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摘要

目的:探讨年轻女性B型乳腺癌(BC)的临床和形态学特征,以确定其生物学侵袭性、对新辅助化疗的反应和预后。材料和方法:一项回顾性研究包括在国家癌症研究所治疗的40岁以下(n = 108)和55岁以上(n = 101)的管腔B亚型BC患者。所有患者均按照ddAC-12T方案接受新辅助化疗。分析TNM分期、肿瘤分化分级、Ki-67表达、激素受体状态、对新辅助化疗的反应(NAC) (RECIST 1.1)、病理形态学分级(Miller - Payne)、无病(DFS)和总生存期(OS)。结果:年轻年龄组的患者更容易出现G3肿瘤(68%对45%),Ki-67高水平>35%(72%对50%),淋巴结受累(71%对59%)。年轻患者中位雌激素受体表达量为35%,而老年患者中位雌激素受体表达量为65%。26%的年轻患者对NAC有完全的组织学反应(老年组为9%)。年轻女性的5年RFS为82.4%,而老年组为94.1%。结论:年轻女性BC的腔内B亚型具有较高的增殖活性、较低的激素敏感性和更频繁的淋巴结累及。尽管对NAC有反应,但该组的DFS更差。结果证实了个性化治疗策略和改进年轻患者早期诊断方案的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CLINICO-MORPHOLOGICAL FEATURES OF THE LUMINAL B SUBTYPE OF BREAST CANCER IN YOUNG WOMEN.

Aim: To evaluate the clinical and morphological features of breast cancer (BC) of the luminal B subtype in young women to determine biological aggressiveness, response to neoadjuvant chemotherapy, and prognosis.

Materials and methods: A retrospective study included luminal B subtype BC patients under 40 years of age (n = 108) and over 55 years (n = 101) treated at the National Cancer Institute. All patients received neoadjuvant chemotherapy according to the ddAC-12T regimen. TNM stages, tumor differentiation grade, Ki-67 expression, hormone receptor status, response to the neoadjuvant chemotherapy (NAC) (RECIST 1.1), pathomorphology grade (Miller - Payne), disease-free (DFS) and overall survival (OS) were analyzed.

Results: Patients of the younger age group were more likely to have G3 tumors (68% vs. 45%), high Ki-67 levels >35% (72% vs. 50%), and lymph node involvement (71% vs. 59%). The median estrogen receptor expression was 35% in the young patients vs. 65% in the older patients. Complete histological response to NAC was achieved in 26% of the young patients (vs. 9% in the older group). Five-year RFS in the young women was 82.4% vs. 94.1% in the older group.

Conclusions: The luminal B subtype of BC in the young women is characterized by the higher proliferative activity, lower hormonal sensitivity, and more frequent lymph node involvement. Despite the response to NAC, this group demonstrates the worse DFS. The results confirm the need for personalized treatment strategies and improved early diagnosis programs in young patients.

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