乳腺癌腋窝淋巴结状态与分子病理特征的关系及临床意义

摘要

Objective To investigate the relationship between axillary lymph node status and molecular pathological features in breast cancer and its clinical significance. Methods A retrospective analysis was performed to study the relationship of axillary lymph node metastasis (LNM), positive lymph node (PLN), and lymph node ratio (LNR) with clinical and molecular pathology features in 300 patients with breast cancer. Results Of 300 cases of breast cancer, the positive rate of axillary LNM was 31.0% (13/42) in the Luminal A subtype of breast cancer, yielding a statistically significant difference (P < 0.05), compared with that of other molecular subtypes. Of 144 patients with positive axillary LNM , there were no significant difference of LNR and PLN between different molecular subtypes of breast cancer (P > 0.05). PLN and LNR were all negatively correlated with E-cadherin expression in breast cancer (P < 0.01 and P < 0.05, respectively), correlated with tumor size and TNM staging (P < 0.05), but not with age, menopausal status, and histological grade (P > 0.05). Conclusion The combined phenotype expression of ER, PR, HER-2, and Ki67 (molecular subtypes) are associated with the incidence of axillary lymph node metastases , and E-cadherin expression deficiency and tumor size growth promote the progression of lymph node metastases in breast cancer.%目的：探讨乳腺癌腋窝淋巴结状态与分子病理特征的关系及其临床意义。方法：回顾性分析300例乳腺癌患者腋窝淋巴结转移（LNM）、淋巴结转移数（PLN）及淋巴结转移率（LNR）与临床分子病理特征的关系。结果：300例乳腺癌患者中Luminal A型LNM阳性率最低，为31．0％（13／42），与其他分子分型相比差异有统计学意义（P ＜0．05）；144例腋窝LNM阳性乳腺癌患者中，不同分子分型的LNR 及PLN 无明显差异（P ＞0．05）。 PLN 和LNR 均与E-cadherin 表达呈负相关（P ＜0．05），与肿瘤直径和 TNM 分期相关（P ＜0．05），而与患者年龄、月经状态及组织学分级相关性无统计学意义（P ＞0．05）。结论：乳腺癌ER、PR、HER-2及Ki67联合表型表达（分子分型）参与腋窝淋巴结转移的发生，而E-cadherin表达缺失和肿瘤直径增长促进了淋巴结转移的进展。