| 摘要: |
| 目的：回顾性研究我中心前哨淋巴结（sentinel lymph node ，SLN）阳性并续行腋窝淋巴结清扫术(axillary lymph node dissection ，ALND)早期乳腺癌患者的临床病理资料，分析腋窝非前哨淋巴结(non-sentinel lymph node，NSLN)转移的相关危险因素，为建立符合本地区的预测模型提供依据。方法：收集温州市人民医院2009年1月—2016年12月102例前哨淋巴结活检阳性并进一步接受腋窝淋巴结清扫术的早期乳腺癌患者临床及病理资料，采用单因素分析及多因素Logistic回归分析方法研究这些临床病理因素与NSLN转移的关系。结果：本研究中共有102例SLN阳性乳腺癌患者进一步接受了ALND，其中36例NSLN发现有转移，NSLN转移检出率是35.3%（36/102)。根据单因素分析结果显示：组织学分级（χ2=8.8214，P=0.0030）、SLN转移率≥0.5（χ2=5.2377，P=0.0221）、SLN转移灶最大径＞2 mm （χ2=4.3290，P=0.0370）是NSLN转移的危险因素。多因素Logistic回归分析结果显示：SLN转移率≥0.5（OR=1.63，95%CI：1.29-2.10，P=0.001）、SLN转移灶最大径＞2 mm(OR=1.34，95%CI：1.02-2.12，P=0.032)是NSLN转移的独立预测因素。结论：SLN转移率≥0.5、SLN转移灶最大径＞2 mm是预测乳腺癌NSLN转移的危险因素,可以作为预测因素，进一步用来构建符合本地区的预测模型。 |
| 关键词: 乳腺癌 前哨淋巴结 非前哨淋巴结 |
| DOI：10.3969/j.issn.1007-6948.2019.03.013 |
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| 基金项目:温州市公益性科技计划项目(Y20160336和Y20170752)，浙江省自然科学基金(LQ17H050002) |
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| The Correlation Factor Analysis of Axillary Non-sentinel Lymph Node Metastasis in Sentinel Lymph Node Positive Breast Cancer Patients: a Study of 102 Patients. |
| ZHENG Ke-si, ZHENG Xiang, ZENG Yong,et al. |
| Department of Oncology, Wenzhou People’s Hospital,the Third Clinical College of Wenzhou Medical University，Wenzhou, Zhejiang (325000), China |
| Abstract: |
| Objective A retrospective study was conducted on the clinicopathologic data of patients with early breast cancer of which sentinel lymph node positive undergoing the axillary lymph node dissection (ALND).And to analyze the related risk factors of axillary non-sentinel lymph node (NSLN) metastasis.And in order to establish a nomogram model suitable for local patients. Methods Clinical and pathological data of the early breast cancer patients with sentinel lymph node positive and further received the axillary lymph node dissection was collected from January 2009 to December 2016 in Wenzhou People’s Hospital .Univariate analysis and multivariate Logistic regression analysis were applied to analyse the relationship between these clinicopathological factors and NSLN metastasis. Results In this study, 102 patients with SLN positive breast cancer were further received ALND, among which 36 cases of NSLN turned out to be metastatic positive, and the NSLN transfer rate was 35.3% (36/102).According to the univariate analysis results:. Histologic classification (χ2=8.8214，P=0.0030), SLN transfer rate≥0.5 (χ2=5.2377，P=0.0221), SLN metastatic foci > 2mm(χ2=4.3290，P=0.0370) were risk factors for NSLN transfer.Multivariate Logistic regression analysis showed that:SLN transfer rate≥0.5(OR=1.63, 95%CI: 1.29-2.10, P=0.001), and SLN metastatic foci > 2mm(OR=1.34, 95%CI: 1.02-2.12, P=0.032)were independent predictors of NSLN transfer. Conclusion SLN transfer rate≥0.5, the maximum diameter of SLN metastases > 2mm may be risk factors of NSLN metastasis in breast cancer,which can be further used to construct a model that suitable for local patients. |
| Key words: Breast cancer sentinel lymph nodes non-sentinel lymph nodes |
