分子标记物预测乳腺癌腋窝前哨淋巴结转移研究

摘要

Objective To decipher the interaction between the primary breast cancer biomarkers (Ki-67, PgR) and the probability of a positive sentinel lymph node (SLN) biopsy. Methods Our dataset consisted of a total number of 243 early-stage breast cancer patients with tumor size less than 5 cm between May 2005 and November 2011. All these patients underwent SLN biopsy. After surgery, factors associated with SLN metastases determined by univariate analysis were included in a multivariate model. Results There were 70 patients with positive SLN biopsy results (28.81%). By multivariate analysis, the stronger independent predictors of SLN metastases were high Ki-67 index (〉 14%) (P= 0.013) and median PgR positive (++) (P= 0.009). Conclusion Both Ki-67 and PgR could predict the SLN metastases in patients with early breast cancer. But the accuracy still required prospective validation in a larger sample.%目的:分析乳腺癌原发肿瘤Ki-67、PgR等分子标记物预测腋窝前哨淋巴结(SLN)转移的可能性.方法:从2005年5月至2011年11月,对243例原发肿瘤最大径≤5 cm、临床腋窝淋巴结阴性的乳腺癌患者进行了SLN活检,以SLN转移作为因变量,将患者的临床特征和分子标记先进行单因素分析,然后把单因素分析中P<0.10的因素作为自变量进一步进行多因素Logistic回归分析.结果:70例(28.81%)患者有SLN转移;多因素分析结果显示当原发肿瘤Ki-67>14%时,发生SLN转移的可能性明显增加(OR=2.66,P=0.013);而原发肿瘤PgR中度阳性(++)较PgR阴性发生SLN转移的可能性亦明显增加(OR=3.167,P=0.009).结论:初步研究表明乳腺原发肿瘤的分子标记Ki-67、PgR表达能预测腋窝SLN转移,但仍需进行更大样本前瞻性研究证实.