前哨淋巴结阴性乳腺癌病人非前哨淋巴结转移相关危险因素分析  

Analysis of risk factors for non-sentinel lymph node metastasis in patients with sentinel lymph node-negative breast cancer

作　　者：张丰哲 童一苇[1] 陈小松[1] 沈坤炜[1] ZHANG Fengzhe;TONG Yiwei;CHEN Xiaosong;SHEN Kunwei(Department of General Surgery,Comprehensive Breast Health Center,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院普外科乳腺疾病诊治中心,上海200025

出　　处：《外科理论与实践》2024年第5期409-413,共5页Journal of Surgery Concepts & Practice

基　　金：Innovative research team of high-level local universitiesin Shanghai(SHSMU-ZDCX20212200)。

摘　　要：目的:分析前哨淋巴结(SLN)阴性乳腺癌病人非前哨淋巴结(non-SLN,NSLN)转移的危险因素.方法:回顾性纳入2009年1月至2024年8月于我中心行全乳切除和前哨淋巴结活检的乳腺癌病人,在SLN阴性且行低位组淋巴结清扫的病人中,行NSLN转移相关危险因素单因素和多因素分析.结果:2 387例SLN阴性病人中,无NSLN转移者2 288例(95.9%),NSLN转移者99例(4.1%).单因素及多因素分析显示:脉管侵犯(LVI)为SLN阴性病人NSLN转移的独立危险因素(13.5%比3.5%;OR=4.14,95%CI:2.27~7.56,P<0.001);与非多中心性乳腺癌相比,多中心性乳腺癌病人具有较高NSLN转移风险的趋势(9.5%比4.1%;OR=2.08,95%CI:0.90~4.81,P=0.089).结论:SLN阴性病人中,存在LVI、多中心性乳腺癌者具有较高NSLN转移风险.Objective To analyze the risk factors for non-sentinel lymph node(NSLN)metastasis in patients with sentinel lymph node(SLN)-negative breast cancer.Methods Patients with breast cancer who underwent mastectomy and SLN biopsy at our center between January 2009 and August 2024 were retrospectively included.Univariate and multivariate analyses were performed in SLN-negative populations underwent low axillary lymph node dissection to identify risk factors for NSLN metastasis.Results A total of 2387 SLN-negative patients were included,including 2288(95.9%)without NSLN metastasis and 99(4.1%)with NSLN metastasis.Univariate and multivariate analyses showed that lymphovascular invasion(LVI)was an independent risk factor for NSLN metastasis in SLN-negative patients(13.5%versus 3.5%;0R=4.14,95%CI:2.27-7.56,P<0.001).Patients with multicentric breast cancer showed a trend towards higher risk of NSLN metastasis compared to other types of breast cancer(9.5%versus 4.1%;0R=2.08,95%CI:0.90-4.81,P=0.089).Conclusions Patients with SLN-negative biopsy who have LVI or multicentric breast cancer are at higher risk for NSLN metastasis.

关 键 词：乳腺癌 前哨淋巴结 非前哨淋巴结转移 脉管癌栓 多中心性乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]