前哨淋巴结阳性早期乳腺癌患者腋窝非前哨淋巴结转移的危险因素分析  

Clinical analysis of risk factors for axillary non-sentinel lymph node metastasis in early breast cancer patients with positive sentinel lymph node

作　　者：张琳琳 朱德淼 闫恒宇 杨鑫凤 马英 Lin-lin Zhang;De-miao Zhu;Heng-yu Yan;Xin-feng Yang;Ying Ma(Jinzhou Medical University First Affiliated Hospital,Jinzhou,Liaoning 121001,China;Anshan Central Hospital,Anshan,Liaoning 114001,China)

机构地区：[1]锦州医科大学附属第一医院,辽宁锦州121001 [2]鞍山市中心医院,辽宁鞍山114001

出　　处：《中国现代医学杂志》2021年第5期15-19,共5页China Journal of Modern Medicine

摘　　要：目的通过分析前哨淋巴结(SLN)活检阳性的早期乳腺癌患者的临床资料与病理特征,探讨其腋窝非SLN转移的危险因素。方法选取2017年7月—2019年7月于锦州医科大学附属第一医院及鞍山市中心医院就诊的SLN活检阳性并行腋窝淋巴结清扫术的早期乳腺癌患者116例,单因素分析其临床和病理资料,多因素Logistic回归分析SLN阳性的早期乳腺癌患者腋窝非SLN转移的危险因素。结果单因素分析显示,两组患者肿瘤直径、组织学分级、脉管内癌栓、分子分型及SLN阳性数目比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,肿瘤直径[O^R=1.784(95%CI:1.091,2.916),P<0.05]、有脉管癌栓[O^R=0.301(95%CI:0.113,0.804),P<0.05]及SLN阳性数≥3枚[O^R=4.977(95%CI:1.114,22.239),P<0.05]是影响腋窝非SLN转移的危险因素。SLN阳性数目≥3枚患者腋窝非SLN转移风险是SLN阳性数目1枚患者的4.977倍。结论对于SLN活检阳性的早期乳腺癌患者,肿瘤直径越小、无脉管内癌栓及SLN阳性数目越少,腋窝非SLN转移可能性越低,对免行腋窝淋巴结清扫有指示意义。Objective To investigate the risk factors of axillary non-sentinel lymph node metastasis by analyzing clinical data and pathological characteristics of early breast cancer patients with positive sentinel lymph node.Methods Clinical and pathological data about early breast cancer patients who underwent axillary lymph node dissection(ALND)with positive result of sentinel lymph node biopsy(SLNB)in Jinzhou Medical University First Affiliated Hospital and Anshan Central Hospital from July 2017 to July 2019 were retrospectively analyzed to explore the risk factors for axillary non-sentinel lymph node metastasis in early breast cancer patients with positive sentinel lymph node.Results There were statistical significance in differences between the two groups in tumor diameter,histological grade,vessel carcinoma embolus,molecular classification,and number of positive sentinel lymph node(P<0.05).With multivariate analysis revealed that the tumor diameter(O^R=1.784,95%CI:1.091,2.916),vessel carcinoma embolus(O^R=0.301,95%CI:0.113,0.804),and number of positive sentinel lymph node(≥3 VS 1,O^R=4.977,95%CI:1.114,22.239)were independent risk factors for axillary non-sentinel lymph node metastasis.The risk of axillary non SLN metastasis in patients with more than 3 SLNs was 4.977 times higher than that in patients with 1 SLN.Conclusion For patients with early breast cancer patients with positive sentinel lymph nodes,the smaller of the tumor diameter,no vessel carcinoma embolus,the less of the number of positive sentinel lymph nodes,the lower possibility of axillary non-sentinel lymph node metastasis,there is guiding significance to avoid ALND.

关 键 词：乳腺肿瘤 SLN活组织检查 淋巴结切除术 

分 类 号：R737.9[医药卫生—肿瘤]