腋窝淋巴结转移对初次保乳手术乳腺癌患者预后的影响  

Effect of Axillary Lymph Node Metastasis on Prognosis of Patients with Breast Cancer Underwent Primary Breast Conserving Surgery

作　　者：宋芳霞[1] 段馨[1] 刘维 SONG Fangxia;DUAN Xin;LIU Wei(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2023年第10期1593-1596,共4页The Practical Journal of Cancer

摘　　要：目的探讨腋窝淋巴结转移对初次保乳手术乳腺癌患者预后的影响。方法选取75例初次保乳手术后复发乳腺癌患者作为研究对象,依据术前腋窝淋巴结状态分为阳性组(32例)及阴性组(43例)。所有患者均行保乳手术+腋窝淋巴结清扫术治疗,比较两组局部区域复发情况、临床病理特征,并分析远处转移、生存情况及复发的影响因素。结果两组局部复发、区域复发及局部+区域复发率相比,差异无统计学意义(P>0.05);75例患者共45例发生远处转移(60.00%),阳性组远处转移率为78.13%(25/32),高于阴性组的46.51%(20/43),有统计学差异(P<0.05);生存分析显示,复发后3年生存率为57.33%(43/75),复发后5年生存率为38.67%(29/75);阳性组复发后总生存率较阴性组低,有统计学差异(P<0.05);多因素分析显示:复发部位、腋窝淋巴结状态为复发患者总生存的独立影响因素(P<0.05)。结论腋窝淋巴结转移可影响初次保乳手术乳腺癌患者预后,能降低术后生存率,缩短患者总生存时间,增加复发后远处转移风险。Objective To investigate the effect of axillary lymph node metastasis on the prognosis of patients with primary breast conserving surgery for breast cancer.Methods 75 patients with recurrence after primary breast conserving surgery were selected as the research objects.They were divided into positive group(32 cases)and negative group(43 cases)according to the preoperative axillary lymph node status.All patients were treated with breast conserving surgery and axillary lymph node dissection.The local recurrence and clinicopathological characteristics of the two groups were compared,and the influencing factors of distant metastasis,survival and prognosis after recurrence were analyzed.Results There was no significant difference in the rates of local recurrence,regional recurrence and local+regional recurrence between the two groups(P>0.05);45 cases of 75 patients had distant metastasis(60.00%),which occurred 2 years after recurrence.The rate of distant metastasis in the positive group was 68.75%(22/32),which was higher than 53.49%(23/43)in the negative group(P<0.05);Survival analysis showed that the 3-year survival rate after recurrence was 57.33%(43/75),and the 5-year survival rate after recurrence was 38.67%(29/75);The overall survival rate after recurrence in the positive group was lower than that in the negative group(P<0.05);Multivariate analysis showed that the recurrence site and axillary lymph node status were independent factors affecting the overall survival of patients with recurrence(P<0.05).Conclusion axillary lymph node metastasis can affect the prognosis of breast cancer patients undergoing primary breast conserving surgery,reduce the postoperative survival rate,shorten the overall survival time of patients,and increase the risk of distant metastasis after recurrence.

关 键 词：乳腺癌 腋窝淋巴结转移 保乳手术 复发 影响因素 预后 

分 类 号：R737.9[医药卫生—肿瘤]