浸润性乳腺癌伴发微钙化的影响因素及与腋窝淋巴结转移的关系  

The influencing factors of invasive breast cancer with microcalcification and its relationship with axillary lymph node metastasis

作　　者：杨丽[1] 朱荔 张春霞[1] 马强[1] 王建东[2] Yang Li;Zhu Li;Zhang Chunxia(General Surgery,Beijing Shunyi Hospital,Beijing 101300,China)

机构地区：[1]北京市顺义区医院普外二科,101300 [2]解放军总医院普通外科

出　　处：《中华保健医学杂志》2020年第6期595-598,共4页Chinese Journal of Health Care and Medicine

基　　金：解放军总医院临床科研扶持基金(2018FC-WJFWZX-2-09)。

摘　　要：目的探讨浸润性乳腺癌(IBC)伴发微钙化(MC)的影响因素及与腋窝淋巴结(ALN)转移的关系。方法回顾性分析2013年09月~2019年11月北京市顺义区医院普通外二科收治的254例IBC患者临床资料,均术前行乳腺X射线检查,分析IBC伴发MC的影响因素及与ALN转移之间的关系。结果MC伴发率为50.54%(136/254),单因素分析显示,年龄>50岁者MC伴发率高于≤50岁者,HER-23+组MC伴发率高于其他组,差异有统计学意义(P<0.05),不同体重指数(BMI)、侧别、象限、生育次数、肿瘤大小、ALN转移状态、ER及Ki-67表达状态组MC伴发率差异无统计学意义(P>0.05)。多因素分析显示,年龄>50岁、外上象限、HER-2+++是伴发MC的独立危险因素(P<0.05)。不同形态MC组ALN转移的差异无统计学意义(P>0.05),不同分布MC组ALN转移差异具有统计学意义(P<0.05),其中沿导管分布组ALN转移率最高。结论IBC患者,MC与年龄、HER-2表达状态存在一定的相关性,伴有沿导管分布的MC者ALN转移可能性更大。Objective To explore the influencing factors of breast microcalcification(MC)in patients with invasive breast cancer(IBC)and its relationship with axillary lymph nodes(ALN)metastasis.Methods We retrospectively analyzed the clinicopathological data of 254 patients with IBC who were admitted to the Second Department of General Surgery of Shunyi Hospital in Beijing from September 2013 to November 2019.Mammography was performed before the operation.The influencing factors of breast MC and the relationship between MC and ALN metastasis were analyzed.Results The incidence of MC was 50.54%(136/254).Univariate analysis:The incidence of MC in patients older than 50 years was higher than that in patients who was 50 years old or younger(P<0.05).The incidence of MC in patients with HER-23+was higher than that in other groups(P<0.05).There was no significant difference in the incidence of MC among different body mass index(BMI),side,quadrant,number of births,tumor size,ALN metastasis,ER and Ki-67 expression(P>0.05).Multivariate analysis:the incidence of MC in patients older than 50 years was higher than that in patients who was 50years old or younger(OR=3.257,P<0.001).The incidence of MC in the outer upper quadrant group was higher than that in other quadrants(OR=2.113,P=0.016).The incidence of MC in patients with HER-23+was higher than that in other groups(OR=6.370,P<0.001).There was no significant difference in the rate of ALN metastasis between the groups with different MC(P>0.05).The difference of ALN metastasis in different distribution MC group was statistically significant,and the rate of ALN metastasis was the highest in the group with MC distributed along the catheter(P<0.05).Conclusion For IBC patients,breast MC is related to age and HER-2 expression status.Those with microcalcifications distributed along the duct are more likely to have ALN metasis.

关 键 词：浸润性乳腺癌 微钙化 腋窝淋巴结 

分 类 号：R737.9[医药卫生—肿瘤]