新辅助化疗对腋窝淋巴结数量影响随机对照临床研究  

Effect of neoadjuvant chemotherapy on the yield of axillary lymph nodes for breast cancer patients

作　　者：刘东滨[1] 孙慎友[1] 孟祥芹[1] 刘丽丽[2] 

机构地区：[1]临沂市人民医院普外科,山东临沂276003 [2]临沂市人民医院病理科,山东临沂276003

出　　处：《中华肿瘤防治杂志》2013年第23期1828-1830,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的：探讨新辅助化疗（neoadjuvant chemotherapy，NAC）对乳腺癌患者腋窝淋巴结数量的影响。方法：2010—03—02—2012—06—30临沂市人民医院乳腺外科收治82例临床Ⅱ～Ⅲ期乳腺癌患者，随机数字表法分为化疗组40例和手术组42例，化疗组以蒽环类CEF或EC方案行3～4个周期NAC，手术组直接接受乳腺癌改良根治术，比较两组患者的腋窝淋巴结数量。结果：40例经NAC的乳腺癌患者中，目标病灶完全缓解（CR）6例，部分缓解（PR）19例，病情稳定（SD）15例，无患者出现疾病进展（PD）。腋窝淋巴结清除以后，化疗组平均检出淋巴结总数为16．7枚（8～28枚），手术组为20．4枚（12～37枚）；平均阳性淋巴结数化疗组为2．1枚（0～13枚），手术组为6．5枚（0～20枚），两组间差异均有统计学意义，P值均〈0．001。结论：乳腺癌患者接受NAC以后，进行腋窝淋巴结清除时，不仅阳性淋巴结减少，得到的淋巴结总数也减少。OBJECTIVE：To investigate the effect of neoadjuvant chemotherapy on the yield of axillary lymph nodes in breast cancer patients. METHODS： A small prospective randomize-controlled clinical trial was carried out between March 2010 and June 2012 in Linyi People＇s Hospital of Shandong province. Eighty-two clinically-staged 2 to 3 breast cancer patients were en- rolled and randomized into 2 groups, of whom 40 patients received 3--4 cycles of anthracycline based chemotherapy first while 42 patients received modified radical mastectomy directly. Numbers of the lymph nodes retrieved during the axillary lymph node dissection were counted and compared between the two groups. RESULTS： Among the neoadjuvant chemotherapy group, evaluation showed complete response （CR） for 6 patients, partial response （PR） for 19 cases and the rest 15 patients remained stable disease （SD）, no patient got progression disease （PD）. Total numbers of the lymph nodes were found differing significantly between neoadjuvant chemotherapy group and the surgery group, with a mean of 16.7 （range 8--28） in the N AC group and 20.4 （12-37） in the surgery group,and the mean number of positive lymph nodes were 2.1 （range 0-13） and 6.5 （range 0--20） respectively （both P〈0. 001）. CONCLUSION： Neoadjuvant chemotherapy reduces both the number of positive lymph nodes and total lymph node counts during the subsequent axillary lymph node dissection.

关 键 词：化学疗法 辅助 乳腺肿瘤 药物疗法 淋巴结 腋 预后 

分 类 号：R737.9[医药卫生—肿瘤]