早期乳腺癌分子分型与非前哨淋巴结转移的相关性探讨  

Correlation analysis between molecular subtypes of early stage breast cancer and the metastasis of non-sentinel lymph node

作　　者：杨璇[1] 赵兴娟[1] 王江芬[1] 高润芳[1] 

机构地区：[1]山西省人民医院乳腺外科,太原030012

出　　处：《中国医师进修杂志》2017年第5期413-417,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨前哨淋巴结阳性早期乳腺癌患者分子分型与非前哨淋巴结转移的相关性，合理预测非前哨淋巴结转移。方法回顾性分析124例前哨淋巴结阳性行腋窝清除的女性乳腺癌患者的相关临床病理资料，并对相关因素进行单因素分析和多因素Logistic回归分析。结果124例患者中，非前哨淋巴结转移45例（36.3%），仅前哨淋巴结阳性79例（63.7%）。单因素分析结果表明，年龄≤ 35岁，前哨淋巴结阳性数量≥ 2枚，前哨淋巴结宏转移与非前哨淋巴结转移密切相关（P≤0.05或〈0.01）；而分子分型、手术方式、肿瘤最大径与非前哨淋巴结转移无关（P〉0.05）。多因素Logistic回归分析结果显示，前哨淋巴结阳性数量和前哨淋巴结阳性病灶情况是前哨淋巴结阳性时影响非前哨淋巴结转移的独立危险因素（OR= 4.589和2.948；P〈0.01或〈0.05）。结论前哨淋巴结阳性病灶情况和阳性数量是影响非前哨淋巴结转移的独立危险因素；但未证实分子分型与非前哨淋巴结转移有关，与临床病理因素结合能够更准确预测非前哨淋巴结转移情况。ObjectiveTo discuss the correlation between molecular subtypes of early stage breast cancer patients with positive sentinel lymph nodes and the metastasis of non-sentinel lymph nodes, and find out the factors predicting the metastasis of non-sentinel lymph nodes.MethodsThe clinical data of 124 female breast cancer patients with sentinel lymph node positive were retrospectively analyzed, and the patients were treated with axillary lymph node dissection. And the correlations were analyzed by single factor analysis and multiple factor Logistic regression analysis.ResultsAmong the 124 patients, non-sentinel lymph node metastasis was in 45 cases （36.3%）, and only sentinel lymph node positive was in 79 cases （63.7%）. The single factor analysis result showed that the age ≤ 35 years, number of sentinel lymph node positive ≥ 2, macrometastasis of sentinel lymph node had correlation with the metastasis of non-sentinel lymph node （P 〈 0.05 or〈0.01）; but the molecular type, operation method, maximum tumor diameter had no correlation with the metastasis of non-sentinel lymph node （P〉0.05）. The multiple factor Logistic regression analysis result showed that the number of sentinel lymph node positive and circumstance of sentinel lymph node positive lesions were the independent risk factors of the non-sentinel lymph node metastasis in patients with sentinel lymph node positive （OR= 4.589 and 2.948; P〈0.01 or〈0.05）.ConclusionsThe circumstance of sentinel lymph node positive lesions and number of sentinel lymph node positive are the independent risk factors of the non-sentinel lymph node metastasis, but the molecular type is not correlated with the metastasis of non-sentinel lymph node. Predicting non-sentinel lymph node metastasis should be combined with clinical and pathological factors.

关 键 词：乳腺肿瘤 淋巴转移 早期诊断 分子分型 回顾性研究 

分 类 号：R737.9[医药卫生—肿瘤]