乳腺癌发生腋窝外三角组织转移特点与影响因素分析  

Characteristics of breast cancer metastases to outer triangle tissue and its influencing factors

作　　者：杨子涵 许守平[1] 庞达[1] YANG Zihan;XU Shouping;PANG Da(Ward 1 of Breast Surgery,Harbin Medical University Cancer Hospital,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学附属肿瘤医院乳腺外科一病区,哈尔滨150081

出　　处：《实用肿瘤学杂志》2022年第3期226-232,共7页Practical Oncology Journal

摘　　要：目的评估外三角组织转移的相关因素,筛选外三角组织转移率低的人群,探讨外三角组织保留的意义。方法选取2020年9月—2021年6月于哈尔滨医科大学附属肿瘤医院行腋窝淋巴结清扫术(Axillary lymph node dissection,ALND)的患者150例进行回顾性研究,将患者以行或未行新辅助化疗(Neoadjuvant chemotherapy,NAC)为标准分组,其中未接受NAC患者95例,接受NAC患者55例。分析临床资料和外三角组织转移的相关性,筛选外三角组织转移的影响因素,绘制ROC曲线评价联合诊断预测外三角组织转移的效果。结果总样本中,22例患者有外三角组织转移。在未行NAC的95例患者中,外三角淋巴结中位数为3.0枚,外三角组织转移19例(20%),彩超腋窝淋巴结尺寸与外三角组织转移相关(P=0.011)。多因素logistic回归分析显示年龄≤55岁、淋巴结较大、PR阳性是外三角组织转移的独立影响因素。ROC曲线分析显示联合诊断的曲线下面积为0.820,特异性为77.8%,敏感性为78.7%。在55例行NAC患者中,外三角组织转移3例(5.5%)。结论淋巴结尺寸和pN分期是外三角组织转移的影响因素,接受NAC的乳腺癌患者可豁免外三角组织清扫。Objective The aims of this study were to evaluate the risk factors of outer triangle tissue metastases,screen the patients with few outer triangle tissue metastases and discuss the significance of outer triangle tissue preservation.Methods A total of 150 patients underwent axillary lymph node dissection(ALND)in Harbin Medical University Cancer Hospital from September 2020 to June 2021 was conducted for this retrospective study.Patients were divided into two groups according to neoadjuvant therapy(NAC),with 95 patients in none NAC group and 55 patients in NAC group.The correlation between clinical data and outer triangle tissue metastases was analyzed.Multivariate logistic regression analysis was used to screen the risk factors and ROC curve was used to evaluate the combined diagnosis.Results In total sample,22 patients were detected outer triangle tissue metastases.Among 95 none NAC patients,19 patients(20%)had outer triangle tissue metastases.The size of lymph node in ultrasound was correlated with outer triangle tissue metastases(P=0.011).Multivariate logistic analysis showed that age≤55 years,lymph node size and progesterone receptor condition were independent influencing factors for outer triangle tissue metastases.According to ROC analysis,the area under the curve was 0.820,specificity was 77.8%,sensitivity was 78.7%.Among 55 NAC patients,3 patients(5.5%)were detected outer triangle tissue metastases.Conclusion Lymph node size and pN stage are the influencing factors for outer triangle tissue metastases.Patients with NAC can be exempted from outer triangle tissue dissection.

关 键 词：乳腺癌 外三角组织 腋窝淋巴结转移 腋窝淋巴结清扫术 

分 类 号：R737.9[医药卫生—肿瘤]