摘要
目的探究前哨淋巴结(sentinel lymph node, SLN)1~2枚阳性乳腺癌患者腋窝非前哨淋巴结(non-sentinel lymph node, NSLN)的转移情况和相关危险因素。方法回顾性分析重庆医科大学附属第一医院2016-2018年SLN 1~2枚阳性并行腋窝清扫的383例乳腺癌患者的临床病理特征,并进行单因素及多因素Logistic分析。结果 383例SLN 1~2枚阳性的乳腺癌患者中,仅149例(38.9%)NSLN阳性。单因素分析结果提示,腋窝超声状态(P<0.001)、SLN阳性数目(P=0.007)、SLN阴性数目(P<0.001)、SLN清扫数目(P<0.001)、SLN转移率(P<0.001)和脉管浸润(lymph-vascular invasion, LVI)(P=0.003)与NSLN转移相关。多因素分析结果表明,腋窝超声状态(P=0.001)、SLN阴性数目(P=0.019)、SLN转移率(P=0.037)、LVI(P=0.039)和HER2过表达型(P=0.026)是腋窝NSLN转移的独立预测因素。结论腋窝超声状态、SLN阴性数目、SLN转移率、脉管浸润和HER2过表达型可作为预测NSLN转移的独立因素,在考虑对SLN仅1~2枚阳性的乳腺癌患者免行腋窝淋巴结清扫时,应重点关注以上临床病理因素。
Objective To investigate the metastasis of non-sentinel lymph node(NSLN) in breast cancer patients with 1~2 positive axillary sentinel lymph nodes(SLN) and the related risk factors. Methods Clinicopathologic parameters of 383 breast cancer patients with 1~2 positive SLNs admitted in our hospital from 2016 to 2018 were collected and retrospectively studied. Univariate and multivariate analysis were used to explore the related predictors of NSLN metastasis. Results In the enrolled 383 patients, only 149(38.9%) were observed with NSLN metastasis. Univariate analysis showed ultrasound axillary lymph node(ALN) status(P<0.001), number of positive SLN(P=0.007), number of negative SLN(P<0.001), number of SLN dissected(P<0.001), metastatic rate of SLN(P<0.001) and lymph-vascular invasion(LVI, P=0.003) were related with NSLN metastasis. Multivariate logistic regressive analysis indicated that ultrasound ALN status(P=0.001), number of negative SLN(P=0.019), metastatic rate of SLN(P=0.037), LVI(P=0.039) and HER2 over-expression(P=0.026) were the independent predictive factors of NSLN metastasis. Conclusion Ultrasound ALN status, number of negative SLN, metastatic rate of SLN, LVI and HER2 over-expression can be used as the independent predictive factors of NSLN metastasis. Attention should be paid to the clinicopathological characteristics when decision of avoiding axillary lymph node dissection in breast cancer patients with 1~2 positive SLNs.
作者
孟垒
肖琪
李钊
何俊峰
王媛媛
谭金祥
MENG Lei;XIAO Qi;LI Zhao;HE Junfeng;WANG Yuanyuan;TAN Jinxiang(Department of Endocrinology and Breast Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2020年第11期1130-1135,共6页
Journal of Third Military Medical University
基金
国家自然科学基金青年科学基金(81102008)。
关键词
乳腺癌
前哨淋巴结
非前哨淋巴结
腋窝淋巴结清扫
breast cancer
sentinel lymph node
non-sentinel lymph node
axillary lymph node dissection
