cT1-2N0期乳腺癌腋窝淋巴结转移相关因素分析

doi:10.13481/j.1671-587x.20150627

摘要/Abstract

摘要：

目的:探讨cT_1-2N₀期乳腺癌患者临床及病理因素与腋窝淋巴结转移的关系,阐明乳腺癌腋窝淋巴结转移规律,发现乳腺癌腋窝淋巴结转移的危险因素,为乳腺癌个体化治疗提供理论依据。方法:选取cT_1-2N₀期乳腺癌患者687例,根据腋窝淋巴结病理结果分为阴性组和阳性组,对临床及病理特征进行分层,采用χ²检验及Logistic回归分析筛选出预测乳腺癌腋窝淋巴结转移的危险因素。结果:687例cT_1-2N₀期乳腺癌患者中,有腋窝淋巴结转移者156例(22.7%)。单因素分析,年龄、cT分期、pT分期、病理分型、脉管浸润、神经浸润、雌激素受体(ER)、孕激素受体(PR)和分子分型等因素与腋窝淋巴结转移有关。多因素分析,年龄<35岁(r=3.440,P=0.010)、cT₂(r=1.770,P=0.007)、浸润性导管癌(r=3.397,P=0.001)、脉管浸润(r=7.434,P=0.000)和Luminal型(r=2.212,P=0.015)是预测腋窝淋巴结转移的独立危险因素。 结论:cT_1-2N₀期乳腺癌患者中,年龄、cT分期、病理分型、脉管浸润和分子分型是腋窝淋巴结是否存在转移的危险因素,其中有无脉管浸润最为重要,术前全面分析和评估临床资料及术前获得的病理结果将有助于正确选择手术术式。

关键词: 乳腺肿瘤, 肿瘤分期, 腋窝淋巴结转移, 超声诊断, 脉管浸润, Luminal型

Abstract:

Objective To investigate the relationships between axillary lymph node metastasis and clinicopathologic features in the patients with cT_1-2N₀ breast cancer and clarify the law of axillary lymph node metastasis,and to find the risk factor,and provide the theoretical basis for individuation therapy. Methods 687 patients with cT_1-2N₀ breast cancer were divided into negative group and positive group according to the pathological results of axillary lymph node, and the clinicopathologic features were layered.The risk factors of axillary lymph node metastasis were screened out by Chi-square test and Logistic regression analysis. Results In 687 cases of cT_1-2N₀ breast cancer,156 (22.7%) cases were observed with axillary lymph node metastasis. The age,cT stage,pT stage,pathological type,vascular invasion,perineural invasion estrogen receptor(ER), progesterone receptor(PR),and molecular subtyping were the factors that influenced axillary lymph node metastasis in univariate analyses.The age<35 years,cT₂,invasive ductal carcinoma,vascular invasion positive and Luminal subtyping were the independent risk factors of axillary lymph nodes metastasis in multivariate analyses(r=3.440,P=0.010;r=1.770,P=0.007;r=3.397,P=0.001;r=7.434,P=0.000;r=2.212,P=0.015). Conclusion In the patients with cT_1-2N₀ breast cancer,the age, cT,pathological type, vascular invasion and molecular subtyping are important predictors of axillary lymph node metastasis and vascular invasion was the most important predictor.The preoperative comprehensive analysis and evaluation of clinical data and preoperative pathological results obtained will help to select the right surgical operation.

Key words: breast neoplasms, neoplasms staging, axillary lymph node metastasis, ultrasonic diagnosis, vascular invasion, Luminal subtyping

中图分类号:

R737.9

崔竹山, 杜烨, 朱珠, 高品, 李佳娓, 范志民. cT_1-2N₀期乳腺癌腋窝淋巴结转移相关因素分析[J]. 吉林大学学报(医学版), 2015, 41(06): 1239-1244.

CUI Zhushan, DU Ye, ZHU Zhu, GAO Pin, LI Jiawei, FAN Zhimin. Analysis on related factors of axillary lymph node metastasis in patients with cT_1-2N₀ breast cancer[J]. Journal of Jilin University Medicine Edition, 2015, 41(06): 1239-1244.

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cT_1-2N₀期乳腺癌腋窝淋巴结转移相关因素分析

Analysis on related factors of axillary lymph node metastasis in patients with cT_1-2N₀ breast cancer

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