ⅢC（pN3a）期乳腺癌淋巴结转移数目或转移率对判断预后的价值  

Prognostic value of metastatic lymph node number or ratio in stage ⅢC（pN3a） breast cancer

作　　者：赵建国[1] 袁媛[1] 张应天[1] 

机构地区：[1]江汉大学附属医院普外科,武汉430015

出　　处：《临床外科杂志》2013年第7期507-509,共3页Journal of Clinical Surgery

摘　　要：目的研究ⅢC（pN3a）期乳腺癌淋巴结转移数目或转移率的细分对判断预后的价值。方法39例ⅢC（pN3a）期乳腺癌，均行全乳切除术加I、Ⅱ平面腋淋巴结解剖术，手术标本采用淋巴结溶脂显示技术提取淋巴结，每枚淋巴结做6张切片，病检肿块病理类型及最大径，免疫组化法检查激素受体状况，规范放、化疗及内分泌治疗，随访7年观查无瘤生存期。结果HIC（pN3a）期乳腺癌病例39例，获取腋淋巴结数11～49枚，中位数35枚。全组中位无瘤生存时间47个月。阳性淋巴结数25枚以上者12例，中位无瘤生存时间35．5个月；阳性淋巴结数10—25枚者27例，中位无瘤生存时间55个月（P〈0．001）。21例淋巴结转移率〉50％，中位无瘤生存时间33个月；18例淋巴结转移率≤50％，中位无瘤生存时间72个月（P〈0．001）。结论ⅢC（pN3a）期乳腺癌复发率及远处转移率高，无瘤生存时间短，尤其淋巴结转移数〉25枚或淋巴结转移率〉50％病例，预后极差。Objective To research the prognostic values of metastatic lymph node number or rati- o in stage ⅢC（pN3a） breast cancer. Methods All 39 patients with stage ⅢC（pN3a） breast cancer were performed mammectomy with axillary level I and ]] lymph node dissection. The axillary samples were treated by lipolysis to take the lymph nodes. Each lymph node was made into 6 sections. Pathological type and maximum diameter of the tumor samples were assessed. Immunohistoehemistry was performed to detect the hormone receptor status. All the patients received chemotherapy, radiotherapy and endocrine therapy if their hormone receptor was positive. All the patients were followed up for 1 - 7 years to observe disease free period. Results A total of 11 to 49 lymph nodes from 39 patients,with a median of 35 lymph nodes. The total disease-free period was 47 months. Twelve patients had more than 25 positive lymph nodes and their median of diseas-free period was 35.5 months. Twenty-seven patients had 10 - 25 positive lymph nodes, and the median of disease free-period was 55 months （P 〈 0. 001 ）. The metastatic lymph node ratio was more than 50% in 21 patients, and their median of disease - free period was 33 months. The metastatic lymph node ratio were no more than 50% in 18 patients, and their median disease-free period was 72 months（ P 〈 0. 001 ）. Conclusion The stage ⅢC（pN3a） breast cancer has higher recurrence and metas- tasis rate and shorter disease-free period. The prognosis is especially poor for cases with more than 25 posi- tive lymph nodes or more than 50% metastatic lymph node ratio.

关 键 词：ⅢC（pN3a）期乳腺癌 淋巴结转移数目 淋巴结转移率 

分 类 号：R737.9[医药卫生—肿瘤]