1-2枚前哨淋巴结阳性乳腺癌患者中非前哨淋巴结转移的影响因素分析  

Analysis of influencing factors to non-sentinel lymph nodes in breast cancer patients with 1 or 2 positive sentinel lymph nodes

作　　者：曹腾飞[1] 唐甜[2] 许清雅 江海瀚 贾海霞[1] 章乐虹[1] CAO Tengfei TANG Tian XU Qingya JIANG Haihan JIA Haixia ZHANG Lehong(Department of Breast Surgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China Department of Pathology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China.)

机构地区：[1]广州医科大学附属第二医院乳腺外科,广州510260 [2]广州医科大学附属第二医院病理科,广州510260

出　　处：《岭南现代临床外科》2017年第1期11-14,共4页Lingnan Modern Clinics in Surgery

基　　金：广东省自然科学基金项目(c15140500000748)

摘　　要：目的分析1~2枚前哨淋巴结(SLN)阳性乳腺癌患者的临床病理因素与非前哨淋巴结(nSLN)转移的关系。方法回顾性分析2012年1月至2015年12月期间广州医科大学附属第二医院乳腺外科1~2枚SLN阳性且同时行腋窝淋巴结清扫的118例早期浸润性乳腺癌患者临床病理资料,分别应用x^2检验及Logistic回归进行单因素及多因素分析。结果 nSLN未转移(nSLN-)组患者64例,nSLN转移(nSLN+)组患者54例。单因素分析显示nSLN转移与肿瘤大小、脉管癌栓、SLN转移比例有关(P=0.001,P=0.030,P=0.002),但与年龄、绝经状态、病理类型、肿瘤位置、核分级、SLN转移数目、ER、PR、C-erBb-2、Ki67无关(均P>0.05)。多因素分析显示肿瘤大小、脉管癌栓、SLN转移比例均为nSLN转移的独立影响因素(OR分别为3.159,2.425,2.258,均P<0.05)。结论肿瘤大小≥2 cm、脉管癌栓、SLN转移比例≥2、3均为1~2枚SLN阳性乳腺癌患者nSLN转移的独立不良影响因素。Objective To evaluate the correlation between non-sentinel lymph nodes（nSLN）metastasis and clinic-pathologic features in primary breast cancer patients with 1 or 2 sentinel lymph nodes（SLN） metastasis.Methods Retrospectively analyzed clinical and pathological data of 118 primary breast cancer patients with 1 or 2 positive sentinel lymph nodes and axillary lymph nodes dissection in The 2nd Affiliated Hospital of Guangzhou Medical University.Chi-square test and Logistic regression were used for univariate and multivariate analysis separately.Results 45.8%（54/118） of all patients with positive non-sentinel lymph nodes metastasis.Univariate analysis revealed nSLN metastasis was associated with tumor size,intravascular tumor thrombus and ratio of SLN metastasis（all P values less than 0.05）.Multivariate analysis showed that tumor size,intravascular tumor thrombus and ratio of SLN metastasis were independent influencing factors of nSLN metastasis（OR=3.159,2.425,2.258,all P values less than 0.05）.Conclusion In 1 or 2 positive SLN breast cancer patients with tumor size≥2cm,intravascular tumor thrombus or ration of SLN metastasis≥2/3 are prone to have metastasis in nSLN.

关 键 词：乳腺肿瘤 前哨淋巴结转移 非前哨淋巴结转移 

分 类 号：R737.9[医药卫生—肿瘤]