乳腺癌前哨淋巴结阳性患者腋窝非前哨淋巴结转移的相关因素分析

摘要

Objective To investigate the related factors of axillary non-sentinel lymph node ( NSLN ) metastasis in breast cancer patients with positive sentinel lymph node ( SLN ) . Methods Ninety-eihgt patients with breast cancer, who were SLN positive according to sentinel lymph node biopsy ( SLNB ) and underwent axillary lymph node dissection ( ALND ) successfully in Shanxi General Hospital from March 2017 to March 2018, were selected as research objects. Thirty-two patients were allocated into NSLN positive group, and 66 patients were allocated into NSLN negative group according to the axillary NSLN condition. The relationship between the clinical indexes and pathological indexes and the axillary NSLN metastasis of breast cancer was analyzed by univariate factor analysis and multivariate factor Logistic regression analysis. Results The number of SLN and number of NSLN positive in NSLN positive group were slightly higher than those in NSLN negative group, but the difference was not statistically significant ( P>0. 05 );and number of SLN positive and number of NSLN in NSLN positive group were significantly higher than those in NSLN negative group ( P<0. 05 ) . Univariate factor analysis showed that long tumor diameter, high grade of histology, estrogen receptor positive ( ER+) , progesterone receptor positive ( PR+) , no amplification of human epidermal growth factor receptor-2 (HER-2), vascular embolism, 2 cases of SLN positive and Luminal B molecular type were the influencing factors of the NSLN metastasis of breast cancer ( P<0. 05 ) . The non conditional logistic multivariate analysis showed that long tumor diameter, high grade of histology, ER+, PR+, no amplification of HER-2, vascular embolism, 2 cases of SLN positive and Luminal B molecular type were independent risk factors of breast tumor NSLN metastasis ( OR >1 , P<0. 05 ) . Conclusions High grade of histology, ER +, PR +, no amplificayion of HER-2, vascular embolism, 2 cases of SLN positive and Luminal B molecular type are independent risk factors of breast tumor NSLN metastasis.%目的 探讨乳腺癌前哨淋巴结(SLN)阳性患者腋窝非前哨淋巴结(NSLN)转移的相关因素.方法 选取2017年3月至2018年3月于山西大医院经前哨淋巴结活检术(SLNB)呈SLN阳性,并随即成功进行腋窝淋巴结清扫(ALND)的乳腺癌患者98例为研究对象.根据患者腋窝NSLN状态分为NSLN阳性组(32例)与NSLN阴性组(66例).采用单因素分析以及多因素Logistic回归分析法分析两组患者各项临床指标及病理指标与乳腺癌腋窝NSLN转移的关系.结果 NSLN阳性组SLN数目、NSLN阳性数目多于NSLN阴性组,但差异未见统计学意义(P>0.05);NSLN阳性组SLN阳性数目、NSLN数目多于NSLN阴性组,差异有统计学意义(P<0.05).经单因素分析发现,肿瘤直径长、组织学分级高、雌激素受体(ER)+、孕激素受体(PR)+、人表皮生长因子受体-2(HER-2)无扩增、有脉管癌栓、SLN阳性数为2枚、分子分型为Luminal B型是导致乳腺癌NSLN转移的影响因素(P<0.05).经非条件Logistic多因素分析发现,肿瘤直径长、组织学分级高、ER+、PR+、HER-2无扩增、有脉管癌栓、SLN阳性数为2枚及分子分型为Luminal B型是导致乳腺癌NSLN转移的独立危险因素(OR>1,P<0.05).结论 组织学分级高、ER+、PR+、HER-2无扩增、有脉管癌栓、SLN阳性数为2枚及分子分型为Luminal B型是导致乳腺癌NSLN转移的独立危险因素.