| Objective: To investigate the clinical characteristics at different agegroups. Methods: In this study,773female cases of mammary cancerdiagnosed by clinical and pathologic manifestations were collected fromdepartment of breast Surgery of affiliated hospital of Luzhou MedicalCollege during the period from Feb.2004to Nov.2007. All these caseswere divided into three age groups, youth-aged group (age≤40),middle-aged group (41-59) and old-aged group (age≥60). Then, thedifferences of course of disease, tumor size, tumor type, ipsilateralaxillary lymph node metastasis, tumor grade, ER, PR, expression ofHer-2, expression of Ki-67, and NPI were retrospectively analyzedamong different age groups. Results:（1）Differences of course disease,tumor grade, axillary lymph node metastases, expression of ER positiveand PR positive, NPI index were found between various age groups, andall the differences were significant statistically through X2test with Pvalue less than0.05,(0.021on course of disease,0.015on tumor grade,0.026on ipsilateral axillary lymph node metastasis,0.006on expressionof ER positive,0.001on expression of PR positive,0.046on expression of Her-2,0.001on expression of Ki-67,0.001on NPI). Youth group caseswere found to be more likely with features of shorter course of disease,higher tumor grade, higher ipsilateral axillary lymph node metastasis,lower expression of ER positive and PR positive, higher NPI score. Andall these parameters show better results in old-aged group.（2）Someparameters had no significant differences among different age groups,however, including expression of Her-2, tumor size, tumor type.（3）theproportion of the cases of more than6months course for each three groupwere28.4%,31.6%and45.8%, respectively. For the tumor size, theproportion of T2-T3term of three groups were59.1%,54.1%,57.1%, theabove two indicators of three age groups were all higher. Conclusion:(1)Youth group cases were more likely to be with features of shorter courseof disease, higher tumor grade, higher ipsilateral axillary lymph nodemetastasis, lower expression of ER positive and PR positive, higher NPIscore, which point out the biological behavior of tumor was weak in thisage group. In addition, most old-aged group indexes show better resultsthan average, while middle-aged group indexes were in the middle levelexcept highest PR positive.(2) All ages in the course of breast cancer Theproportion of cases with duration more than6months and tumor size interm of T2-3were higher, particularly in the elderly group T3tumorproportion was higher than other age groups, therefore school tostrengthen the secondary prevention of breast cancer is expected to further improve the prognosis of patients with different age groups,especially elderly group breast cancer. Objective:To investigate the correlation between NPI Index (NottinghamPrognostic Index) and immunohistochemical Index at different ages.What’s more, to explore the molecular differences in classification andcharacteristics of the outcome at different age patients with breast cancer,to provide the theoretic foundation for clinical individual treatment ofbreast cancer for our hospital. Methods: In this chapter,773female caseswith breast cancer who were diagnosed by clinical and pathologicmanifestations were collected from department of breast Surgery ofaffiliated hospital of Luzhou Medical College during the period from Feb.2004to Nov.2007. All these cases are divided into three age groups,youth-aged group (age≤40), middle-aged group (41<age<59) andold-aged group (age≥60). Based on our sample, we discusses whether ifthe correlations between clinical parameter of NPI index andimmunohisto chemical parameters, including ER, PR, expression ofHer-2, expression of Ki-67were statistically significant, according tocases at different age groups. Also, the differences of molecularclassification among different age groups were retrospectively analyzedand differently compared. Furthermore, the differences of prognosis due to various age groups were concluded by follow up analysis on DFA andOS in five years. Finally, Cox regressive prediction model was proposedin this chapter to discuss the relationship among age, clinical pathologicalparameters and prognosis. Results:(1) negative correlation between NPIindex and ER (The different age groups the ER and NPI correlationcoefficient respectively:0.183,0.094,0.521, P values were0.039,0.013,＜0.001, respectively), positive correlation between NPI index and Ki-67were found coincidently in each age group (Different age groups the Ki-67and NPI index correlation coefficient respectively:0.532,0.564,0.731,P＜0.001).(2) Differences of molecular classification were foundbetween various age groups, and all the differences were significantstatistically with P value0.047was less than0.05, proportion of basal celltype were31%,21.6%and18.9%respectively. Youth group cases werefound to be with features of higher proportion of basal cell type (ortriple-negative breast cancer). And these parameters show better inold-aged group.(3) The DFS index of youth group, middle-aged groupand old-aged group were68.1%、78.0%、83.8%respectively with P valueof0.039, and OS index are98.6%、83.7%、85.1%respectively with Pvalue of0.516. Furthermore, this paper finds that tumor size（P=0.004，95%CI0.336-0.817）, lymphatic metastasis (P=0.046，95%CI1.009-2.443),NPI (P＜0.001，95%CI2.797-5.477), ER（P=0.009，95%CI0.252-0.822),Her-2(P=0.026，95%CI1.071-2.992) and molecular classification (P=0.004,95%CI1.360-5.280) were independent factors impacting onDFS. Conclusion:(1) NPI index was found to be used to explain mostclinical indexes, including tumor size, tumor grade and lymphaticmetastasis. What’s more, negative correlation between NPI index and ER,positive correlation between NPI index and Ki-67were coincident in eachage group. Also, NPI can be used to evaluate prognosis of mammarycancer patients in all the age groups without any expect.(2)Youth groupcases were more likely to be with features of higher proportion of basalcell type, which point out the biological behavior of tumor was weak inthis age group. In addition, old-aged group cases get better molecularclassification results compare to the other age groups.(3) Last but notless important, youth-age group cases had unfavorable prognosis withlower DFS, however, age was not the independent negative factoraffecting on that. |
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