早期乳腺癌前哨淋巴结阳性预测因素分析  

Analysis of predictive factors affecting sentinel lymph node status in early breast cancer patients

作　　者：焦得闯[1] 乔江华[1] 卢振铎[1] 李连方[1] 张恒伟[1] 刘慧[1] 崔树德[1] 刘真真[1] 

机构地区：[1]郑州大学附属肿瘤医院河南省肿瘤医院乳腺科,450008

出　　处：《中华肿瘤杂志》2014年第3期198-201,共4页Chinese Journal of Oncology

摘　　要：目的探讨早期乳腺癌前哨淋巴结阳性的预测因素。方法回顾性分析2010年7月至2013年8月河南省肿瘤医院收治的l038例接受前哨淋巴结活检术患者的临床病理资料。各项临床病理特征与前哨淋巴结转移的相关性分析采用Logstic回归模型。结果全组患者均为女性，年龄22～84岁，平均48．6岁；前哨淋巴结的平均检出数为3．8枚。1038例早期乳腺癌患者的前哨淋巴结转移率为22．9％（238／1038）。单因素分析显示，肿瘤大小、肿瘤位置、病理类型、激素受体状态和Ki-67标记指数与前哨淋巴结的转移有关（均P〈0．05）。多因素分析显示，肿瘤位置、肿瘤大小、病理类型和激素受体状态是前哨淋巴结转移的独立预测因素（OR分别为2．940、4．278、4．097和2．926，均P〈0．05）。结论激素受体阴性、浸润性非特殊类型癌、肿瘤直径〉2em和肿瘤位于外上象限是早期乳腺癌前哨淋巴结转移的独立不良因素。Objective To investigate the predictive factors affecting sentinel lymph node status in early breast cancer patients. Methods Clinicopathological data of 1 038 patients with early breast cancer, who underwent sentinel lymph node biopsy in Henan Tumor Hospital between July 2010 and August 2013, were reviewed. Logistic regression analysis was performed to identify the relevance of clinicopathological features with sentinel lymph node metastases. Results This group was consisted of 1 038 female patients with an average of 48.6 years. Positive sentinel lymph nodes were found in 22.9% （238/1 038 ） of the patients. The average number of sentinel lymph nodes removed by surgery was 3.8. Tumor size, tumor location, histopathology, ER/PR status and Ki-67 level were significantly correlated with SLN metastasis （P 〈 0.05 for all）. All the above factors but Ki-67 level were significant independent predictors for SLN metastasis（P 〈 0. 01 for all）. Conclusion Negative hormone receptor status, invasive cancer of non- specific histopathological type, tumor size 〉 2 cm, and tumor location in the outer upper quadrat are independent predictive factors of sentinel lymph node metastasis in patients with early breast cancer.

关 键 词：乳腺肿瘤 前哨淋巴结 肿瘤转移 淋巴结 预测因素 

分 类 号：R737.9[医药卫生—肿瘤]