乳腺癌前哨及非前哨淋巴结转移危险因素分析  

Analysis of risk factors for sentinel lymph node and non-sentinel lymph node metastasis in breast cancer

作　　者：王醒蒙 蔡如玉 吴娴 叶超然 夏添松[1] 刘晓安[1] WANG Xingmeng;CAI Ruyu;WU Xian;YE Chaoran;XIA Tiansong;LIU Xiaoan(Department of Breast Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;Department of General Surgery,the First People’s Hospital of Yancheng City,Yancheng 224006,China)

机构地区：[1]南京医科大学第一附属医院乳腺外科,江苏南京210029 [2]盐城市第一人民医院普外科,江苏盐城224006

出　　处：《南京医科大学学报（自然科学版）》2020年第5期687-692,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金面上项目(81572602)。

摘　　要：目的:探讨浸润性乳腺癌患者前哨淋巴结(sentinel lymph node,SLN)及非前哨淋巴结(non-sentinel lymph node,NSLN)转移的危险因素。方法:收集南京医科大学第一附属医院2016年8月—2019年2月收治入院并接受前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)的845例浸润性乳腺癌患者,对其临床及病理资料进行回顾性分析,采用单因素及多因素Logistic回归分析方法研究各种临床病理参量与SLN及NSLN转移的关系。结果:肿瘤大小、雌激素受体(ER)状态、孕激素受体(PR)状态、脉管侵犯、Ki-67、p53是SLN转移的危险因素。多因素Logistic回归分析结果:肿瘤大小、PR状态、脉管侵犯是前哨淋巴结转移的独立危险因素。SLN阳性患者中进一步行胶窝淋巴结清扫术160例,其中NSLN未转移130例(81.3%),NSLN转移30例(18.7%)。单因素Logistic回归分析结果:PR状态、SLN阳性数量是NSLN转移的危险因素。多因素Logistic回归分析结果:SLN阳性数量是NSLN转移的独立危险因素。结论:肿瘤大小、PR状态、脉管侵犯是SLN转移的独立危险因素;SLN阳性数量是NSLN转移的独立危险因素。Objective:To explore the risk factors of sentinel lymph node(SLN)and non-sentinel lymph node(NSLN)metastases in patients with invasive breast cancer.Methods:We retrospectively analyzed the clinical-pathologic characteristics of 845 patients with invasive breast cancer who underwent Sentinel Lymph Node Biopsy(SLNB)in the First Affiliated Hospital of Nanjing Medical University from August 2016 to February 2019.Univariate logistics regression and multivariate logistics regression methods were used to explore the relationship between clinical-pathological parameters and the metastasis of SLN and NSLN.Results:A total of 845 patients were recruited in this study,of which 160 were SLN positive(18.9%)and 685 were negative(81.1%).Results:of univariate logistic regression analysis:Tumor size,ER status,PR status,lymphovascular invasion,Ki-67,and p53 were risk factors for SLN metastasis.Multivariate Logistic regression analysis results:Tumor size,PR status,lymphovascular invasion were independent risk factors for SLN metastasis.160 patients with SLN positive patients were further received ALND,among which,NSLN turned out to be negative in 130 cases(81.3%),and positive in 30 cases(18.7%).Univariate logistic regression showed that PR status and the number of positive SLNs were the risk factors for NSLN metastasis.Multivariate Logistic regression analysis indicated the number of positive SLNs was an independent risk factor for NSLN metastasis.Conclusion:Tumor size,PR status,lymphovascular invasion were independent risk factors for SLN metastases;the number of positive SLNs was an independent risk factor for NSLN metastases.

关 键 词：浸润性乳腺癌 前哨淋巴结 非前哨淋巴结 危险因素 

分 类 号：R737.9[医药卫生—肿瘤]