乳腺癌术后无瘤生存率的影响因素及腋窝淋巴结检测数目的临床意义

摘要

Objective To investigate the relative factors influencing disease-free survival(DFS)rate in breast cancer and clinical significance of the number of axillary lymph node dissection .Methods Clinical data of 138 cases of breast cancer pa-tients who received modified radical mastectomy and axillary lymph node dissection were studied retrospectively .Positive axillary lymph nodes and disease-free survival time and influencing factors of patients with negative axillary lymph node were analyzed by Kaplan-Meier and multivariate logistic regression analysis .Results 5-year overall survival rate and DFS rate in patients with negative lymph nodes were 90.7% and 86.7%,respectively.5-year overall survival rate and DFS rate in patients with positive lymph nodes were 72.6%and 64.7%,respectively.There had statistical difference(P<0.05).Single factor analysis and multi-variate logistic regression analysis showed that the number of positive lymph node ,the number of lymph node dissection ,HER-2 were risk factors influencing the 5-year DFS of patients with positive lymph node .HER-2 was the main risk factor influencing the 5-year DFS of patients with negative lymph node .Conclusion Axillary lymph node metastasis and HER-2 are major factors in-fluencing the 5-year DFS of breast cancer patients .Increase the number of lymph nodes detection could improve the 5-year DFS of breast cancer patients .%目的：探讨乳腺癌术后无瘤生存率的影响因素及腋窝淋巴结清扫及检测个数的临床意义。方法回顾性分析138例行乳腺癌手术并腋窝淋巴结清扫患者的临床资料，采用Kaplan-Meier法和Logistic多因素回归分析腋窝淋巴结阳性和腋窝淋巴结阴性患者的无瘤生存时间及影响因素。结果淋巴结阴性患者5年总生存率为90．7％，5年无瘤生存率为86．7％，淋巴结阳性患者5年总生存率为72．6％，5年无瘤生存率为64．7％，2组差异具有统计学意义（ P＜0．05）。单因素分析及Logistic多因素回归分析提示淋巴结阳性数目，淋巴结清扫个数，HER-2状态是腋窝淋巴结阳性患者5年无瘤生存率的危险因素；而HER-2是腋窝淋巴结阴性患者5年无瘤生存率的主要危险因素。结论腋窝淋巴结是否转移、HER-2状态是乳腺癌患者5年无瘤生存率的重要影响因素，增加淋巴结检测个数可改善腋窝淋巴结阳性患者的5年无瘤生存率。