摘要
目的：探讨乳腺癌新辅助化疗后腋窝淋巴结分期和病理缓解状态与预后的关系。方法回顾性分析653例新辅助化疗前腋窝淋巴结阳性乳腺癌患者的临床病理资料。结果653例患者中，术后腋窝淋巴结ypN0期242例（37．1％），ypN1期182例（27．8％），ypN2期135例（20．7％），ypN3期94例（14．4％）；腋窝淋巴结病理完全缓解242例（37．1％），病理部分缓解411例（62．9％）。全组患者中位随访时间为59．3个月，其中ypN0期、ypN1期、ypN2期和ypN3期患者的5年生存率分别为93．4％、93．4％、87．4％和83．0％，差异有统计学意义（P＝0．046）。 Cox多因素分析的结果显示，术后腋窝淋巴结病理缓解状态是影响患者总生存和无病生存情况的主要因素（ RR＝1．051，P＝0．007；RR＝1．028，P＝0．028）。结论新辅助化疗后腋窝淋巴结分期和病理缓解状态是预测乳腺癌患者预后的有效指标。
Objective To analyze the relevance between lymph node status and pathological response after neoadjuvant chemotherapy and survival in breast cancer patients. Methods The clinicopathological data of 653 needle biopsy proved breast cancer patients, who underwent neoadjuvant chemotherapy and surgery in our hospital from July 1998 to April 2012, were retrospective analyzed.Results The median follow up time was 59.3 months.The 653 cases were classified into ypN0 （242 cases） , ypN1 （182 cases）, ypN2 （135 cases）, and ypN3 （94 cases） stages, and the 5-year overall survival rates in the four groups were 93.4%, 93.4%, 87.4%, and 83.0%, respectively.The Log rank test showed a significant difference in the overall survival rates between the ypN0, ypN1, ypN2 stages and ypN3 stage （ P=0.046） .No significant differences were observed between the disease free survival （ DFS） rates in the four groups （ P 〉0.05）.Multivariate analysis indicated that the postoperative pathological response of metastatic lymph nodes was a major prognostic factor affecting the overall survival and disease-free survival （RR=1.051,P=0.007;RR=1.028,P=0.028）.Conclusion The stage and pathological response of axillary lymph nodes after neoadjuvant chemotherapy are effective indicators for predicting the OS and DFS in breast cancer patients.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2015年第3期195-199,共5页
Chinese Journal of Oncology
关键词
乳腺肿瘤
新辅助化疗
腋窝淋巴结
预后
Breast neoplams
Neoadjuvant chemotherapy
Axillary lymph node
Prognosis
