乳腺癌神经浸润与临床病理特征的关系及预后分析  

Relationship of perineural invasion with clinicopathological features and prognosis in breast cancer patients

作　　者：彭浦超 陈莉杰 宣浩军 姚敏 邓再兴 张昕 丁秀芳 PENG Puchao;CHEN Lijie;XUAN Haojun;YAO Min;DENG Zaixing;ZHANG Xin;DING Xiufang(Graduate School,Zhejiang Chinese Medical University,Hangzhou,Zhejiang 310053,China;不详)

机构地区：[1]浙江中医药大学研究生院,浙江杭州310053 [2]湖州市妇幼保健院乳腺科,浙江湖州313000 [3]浙江省肿瘤医院乳腺外科,浙江杭州310000 [4]湖州市妇幼保健院病理科,浙江湖州313000

出　　处：《中华全科医学》2025年第1期55-58,共4页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2023KY588)。

摘　　要：目的神经浸润在乳腺癌中的预后和生存意义尚未明确,本研究旨在分析其与乳腺癌临床病理特征的关系及对预后的影响,为精准评估乳腺癌的预后提供依据。方法选取2018年1月—2021年12月在湖州市妇幼保健院诊治的159例乳腺癌患者为研究对象,根据患者是否存在神经浸润,分为神经浸润组(43例)和非浸润组(116例)。比较2组临床病理特征,采用单因素及多因素logistic回归分析影响乳腺癌发生神经浸润的危险因素,用Kaplan-Meier法绘制生存曲线,比较2组无病生存期的差异。采用Cox回归分析探究影响乳腺癌患者预后的因素。结果159例乳腺癌中,43例(27.0%)发生神经浸润。单因素分析显示,2组T分期、腋窝淋巴结转移、TNM分期、Ki-67表达水平差异均有统计学意义(P<0.05);多因素logistic二元回归分析显示,腋窝淋巴结转移、TNM分期、Ki-67表达水平均为乳腺癌发生神经浸润的独立影响因素(P<0.05)。43例伴神经浸润患者无病生存率为67.4%,116例无神经浸润患者无病生存率为87.9%,差异有统计学意义(χ^(2)=12.693,P<0.05)。单因素Cox回归分析显示,雌激素受体、孕激素受体、T分期、TNM分期、核分级、神经浸润、分子分型均为患者预后的影响因素(P<0.05);多因素Cox回归分析显示,三阴型乳腺癌、神经浸润均为患者的独立预后因素(P<0.05)。结论腋窝淋巴结转移、TNM分期、Ki-67高表达是乳腺癌发生神经浸润的独立相关因素,神经浸润是乳腺癌患者的独立预后因素,可作为评价预后的指标。Objective The prognostic and survival significance of perineural invasion in breast cancer was not clear,the relationship of perineural invasion with clinicopathological characteristics and the effect on the prognosis of breast cancer were analyzed,so as to provide a basis for accurate evaluation of the prognosis of breast cancer.Methods A total of 159 breast cancer patients in Huzhou Maternal and Child Health Care Hospital from January 2018 to December 2021 were selected as the study subjects.According to the presence of perineural invasion,the patients were divided into the PNI-positive group(n=43)and the PNI-negative group(n=116).The clinicopathological characteristics of two groups of breast cancer patients were compared,and univariate and multivariate logistic regression analysis were used to analyze the risk factors of neural invasion of breast cancer.Moreover,the Kaplan-Meier method was used to draw survival curves to compare the differences in disease-free survival between the two groups of patients.Meantime,Cox regression analysis was used to explore the factors affecting the prognosis of breast cancer patients.Results Among 159 cases of breast cancer,43 cases(27.0%)had a perineural invasion.Univariate analysis showed that T stage,axillary lymph node metastasis,TNM staging,and the expression levels of Ki-67 of breast cancer were correlated with perineural invasion(P<0.05);In the logistic binary regression analysis with multiple factor analysis,axillary lymph node metastasis,TNM staging,and the expression levels of Ki-67 were independent factors influencing the occurrence of breast cancer perineural invasion(P<0.05).The disease-free survival rate of 43 patients with nerve infiltration was 67.4%,while the disease-free survival rate of 116 patients without nerve infiltration was 87.9%.The difference in disease-free survival rates between the two groups was statistically significant(χ^(2)=12.693,P<0.05).The results of univariate Cox regression analysis showed that estrogen receptor,progesterone receptor,T s

关 键 词：乳腺癌 神经浸润 预后 

分 类 号：R737.9[医药卫生—肿瘤] R730.7[医药卫生—临床医学]