淋巴结转移比率在预测淋巴结转移乳腺癌患者预后中的价值  

Value of Metastatic Lymph Node Ratio for Predicting Prognosis of Patients with Node-Positive Breast Cancer

作　　者：李永峰[1] 吴云飞[1] 张慧[2] 

机构地区：[1]中国医科大学附属第一医院乳腺外科,辽宁沈阳110001 [2]中国医科大学附属第一医院检验科,辽宁沈阳110001

出　　处：《中国普外基础与临床杂志》2011年第7期750-754,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨淋巴结转移比率（MLNR）在预测淋巴结转移乳腺癌患者预后中的应用价值。方法回顾性分析94例接受改良根治术治疗的淋巴结转移乳腺癌患者的临床资料,并对患者生存情况及影响预后的相关因素进行分析。结果 94例患者随访时间为12-75个月,中位随访时间为64个月,5年生存率为72.34%（68/94）。总MLNR为0.31（486/1 553）。单因素分析显示原发肿瘤大小、淋巴结转移数目、ER状态、放疗与否和MLNR影响淋巴结转移乳腺癌患者的预后（P〈0.05）,而患者年龄、绝经与否、PR状态、内分泌治疗与否和组织学类型与预后无关（P〉0.05）。多因素分析发现MLNR（OR=2.565,95%CI=1.043-6.309,P=0.040）和肿瘤大小（OR=2.220,95%CI=1.045-4.716,P=0.038）是影响淋巴结转移乳腺癌患者预后的独立因素。结论 MLNR是影响淋巴结转移乳腺癌患者的独立预后因素,且其预测效果比淋巴结转移数目更为准确和客观。Objective To evaluate the prognostic significance of metastatic lymph nodes ratio（MLNR） in patients with node-positive breast cancer.Methods The clinical data of 94 patients with node-positive breast cancer underwent modified radical mastectomy were retrospectively analyzed.The survival rate and prognosis factors of patients with complete follow-up data were assessed by log-rank test and multivariate regression analysis.Results The survival time of 94 patients ranged from 12-75 months,with median 64 months.The 5-year overall survival rate was 72.34%（68/94）.The total MLNR was 0.31（486/1 553）.Univariate analysis demonstrated that the survival was influenced significantly by tumor size,number of lymph node metastasis,MLNR,ER status,and radiotherapy or not（P〈0.05）,but not by patient＇s age,menopause or not,PR status,endocrine therapy or not,and histological type（P〈0.05）.Multivariate analysis showed that MLNR（OR=2.565,95%CI=1.043-6.309,P=0.040） and tumor size（OR=2.220,95%CI=1.045-4.716,P=0.038） were independent prognostic factors for the patients with node-positive breast cancer.Conclusion MLNR is a major independent prognostic factor for the patients with node-positive breast cancer,which is more accurate than the number of metastatic lymph nodes in predicting the survival of patients with node-positive breast cancer.

关 键 词：乳腺癌 淋巴结切除术 肿瘤转移 肿瘤分期 预后 

分 类 号：R737.9[医药卫生—肿瘤]