阴性淋巴结数对浸润性乳腺癌预后的评估价值  

The Value of Negative Lymph Node Count in Predicting Prognosis of Invasive Breast Cancer

作　　者：吴昊 黄雅静 胡晓鹏 罗智勇 Wu Hao;Huang Yajing;Hu Xiaopeng(Department of General Surgery,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Breast and Thyroid Surgery,Tongji Hospital,Tongji Medical Colege,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院普外科,武汉430030 [2]华中科技大学同济医学院附属同济医院甲状腺乳腺外科,武汉430030

出　　处：《华中科技大学学报（医学版）》2022年第2期224-228,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家自然科学基金资助项目(No.81502373)。

摘　　要：目的分析阴性淋巴结数与浸润性乳腺癌预后的关系。方法提取SEER数据库中乳腺癌患者的临床数据并进行筛选。使用X-tile软件确定阴性淋巴结数的最佳截断值。使用Kaplan-Meier生存曲线和多因素Cox回归模型分析影响乳腺癌特异性生存的因素。结果阴性淋巴结数4和9是最佳截断值,可将患者分为高、中、低风险组。单因素回归分析显示阴性淋巴结数、年龄、人种、肿瘤分级、T和N分期、雌/孕激素受体状态以及是否接受放疗与预后相关。多因素回归分析表明调整上述其他相关因素一致后,阴性淋巴结数越多预后越好,证明阴性淋巴结数是影响乳腺癌预后的独立危险因素。为了证明多因素分析的结果,该研究依据激素受体水平进行亚组分析,进一步验证了阴性淋巴结数预测生存的独立性。结论阴性淋巴结数是乳腺癌预后独立且有效的预测因子,与其他预后因素结合可更好地预测乳腺癌患者的生存。Objective To evaluate correlation between negative lymph node(NLN)count and prognosis of invasive breast cancer.Methods Clinical characteristic data of patients were collected and organized from SEER database.The X-tile plots was used to determine the optimal cutoffs for NLN count.Kaplan-Meier survival curves and multivariate Cox regression model were used to assess the risk factors for breast cancer-specific survival(BCSS).Results The X-tile plots identified that the cutoff value of 4 and 9 could be used to divide the patients into high,middle and low risk subgroups in terms of BCSS.According to univariate analysis,patients with NLN count≤1,over 60 years old,black people,higher tumor grade,higher T or N stage,negative hormone receptor and no radiotherapy history would be more likely to suffer poor survival outcome.Multivariate regression analysis showed that NLN count was positively associated with the prognosis after adjusting related factors mentioned above,proving that NLN count was an independent risk factor affecting the prognosis of breast cancer.Subgroup analysis showed that NLN count could still predict survival independently in different hormone receptor status,which is consistent with multivariate analysis result.Conclusion The NLN count is an independent prognostic factor for breast cancer patients.Combining NLN count with other prognostic factors will built a better predicting system for the survival of breast cancer patients.

关 键 词：阴性淋巴结数 乳腺癌 SEER数据库 预后 

分 类 号：R737.9[医药卫生—肿瘤]