17例乳腺癌腹股沟淋巴结转移患者的临床特征和预后分析  

Clinicopathological features and prognostic factors of breast cancer patients with inguinal lymph node metastases： a report of 17 cases

作　　者：李倩[1] 徐兵河[1] 张频[1] 李青[1] 袁芃[1] 王佳玉[1] 罗扬[1] 马飞[1] 樊英[1] 李俏[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院内科,100021

出　　处：《中华肿瘤杂志》2013年第3期207-211,共5页Chinese Journal of Oncology

摘　　要：目的研究乳腺癌合并腹股沟淋巴结转移患者的临床表现、病理学特点和影响预后的因素。方法收集1999年1月至2010年12月收治的17例乳腺癌合并腹股沟淋巴结转移患者的临床资料，分析其临床病理特征和预后影响因素。结果17例伴有腹股沟淋巴结转移的乳腺癌患者占同期乳腺癌患者收治总数的0．11％，其中合并其他部位转移15例（88．2％），单纯腹股沟淋巴结转移2例（11．8％）。17例患者均接受了雌激素受体（ER）和（或）孕激素受体（PR）检测，10例（58．8％）阳性，7例（41．2％）阴性。13例患者接受了表皮生长因子受体2（HER-2）检测，其中4例（30．8％）阳性。16例患者接受手术治疗，术中发现9例患者的腋窝淋巴结转移≥4枚。17例患者均接受化疗。中位随访时间为156个月，全组患者的5年生存率为49．9％。单因素分析的结果显示，腋窝淋巴结转移I〉4枚、ER和（或）PR阴性、辅助化疗周期数≤6个、确诊时临床分期为Ⅲ、Ⅳ期以及发现乳腺癌至腹股沟淋巴结转移的时间≤36个月者的中位无进展生存时间明显缩短（均P〈0．05）。腋窝淋巴结转移≥4枚、ER和（或）PR阴性、辅助化疗周期数≤6个、首次复发为多发远处转移、发现乳腺癌至腹股沟淋巴结转移的时间≤36个月以及合并胸腔积液者的中位生存时间明显缩短（均P〈0．05）。多因素分析结果显示，发现乳腺癌至腹股沟淋巴结转移的时间是影响患者无进展生存时间的独立因素（P〈0．05）。结论影响乳腺癌合并腹股沟淋巴结转移患者预后的主要因素为腋窝淋巴结转移数目、激素受体状态、辅助化疗周期数、首次复发转移类型、发现乳腺癌至腹股沟淋巴结转移的时间以及是否有胸腔积液。术后定时全面复查、对高危人群及时给予强化治疗对改善患者的预后可能有一定的积极意义，但也需要�Objective To analyze the clinicopathological features and prognostic factors of breast cancer patients with inguinal lymph node metastases. Methods Seventeen breast cancer patients with inguinal lymph node metastases were treated from January 1999 to December 2010 in our cancer center. All of the patients had a history of breast cancer without other primary cancer. Their clinicopathological characteristics and prognostic factors were surveyed. Results The frequency of breast cancer cases with inguinal lymph node metastaseis consisted of 0.11% of the total number of breast cancer patients in the same period. Two patients （ 11.8% ） had inguinal lymph node metastasis only, and multi-site metastases were observed in the remaining 15 （88.2%） patients. The number of ER- and/or PR-positive and negative were 10 （58.8%） and 7 （41.2%） cases, respectively, and among the 13 cases who underwent HER-2 test, the number of HER-2-positive was 4 （30.8%）. For the 16 patients who underwent surgery, 9 patients were detected with metastatic axillary lymph nodes equal or greater than 4. All of the 17 patients were treated with chemotherapy. The median follow-up time was 156 months. The 5-year overall survival rate was 49.9%. Univariate analysis revealed that metastatic axillary lymph nodes≥4, ER- and （or） PR-negative, adjuvant chemotherapy ≤6 cycles, disease stage asⅢ/Ⅳ at diagnosis and the period from diagnosis of breast cancer to the occurrence of inguinal lymph node metastasis ≤36 months were predictors of shorter PFS （P 〈 0.05 ）.Metastatic axillary lymph nodes ≥ 4, ER- and （or） PR-negative, adjuvant chemotherapy ≤ 6 cycles, primary recurrence as multiple distant metastases, the period from diagnosis of breast cancer to the occurrence of inguinal lymph nodes metastasis ≤36 months and pleural effusion were predictors of shorter OS （P 〈 0.05 ）. Multivariate analysis revealed that the period from diagnosis of breast cancer to the occurrence of inguinal lymph node metastasis was an

关 键 词：乳腺肿瘤 肿瘤转移 淋巴结 腹股沟 预后 

分 类 号：R737[医药卫生—肿瘤]