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目的前哨淋巴结活检术(sentinel lymph nodes biopsy,SLNB)已经广泛应用于乳腺癌外科治疗,临床发现部分转移淋巴结仅局限于前哨淋巴结。本研究分析前哨淋巴结(sentinel lymph nodes,SLN)阳性乳腺癌患者非前哨淋巴结(non-sentinel lymph nodes,NSLN)转移的影响因素,从而避免不必要的腋窝淋巴结清除(axillary lymph node dissection,ALND)。方法回顾性分析聊城市人民医院乳腺外科2013-07-1-2015-06-30SLNB阳性行ALND的77例女性乳腺癌患者临床病理资料,分析NSLN转移的影响因素。结果在SIN清除个数≥4个的情况下,单因素分析发现阳性SLN≥2个(χ~2=10.109,P=0.01)以及LuminalB型患者(χ~2=6.442,P=0.02)发生NSLN转移的风险高。Logistic回归进行多因素分析发现,阳性SLN≥2个是影响NSLN转移的独立危险因素(OR=207.833,95%CI为1.430~30 201.980,P=0.036)。结论阳性SLN数和分子亚型是影响NSLN转移的危险因素,阳性SLN≥2个是影响NSLN转移的独立危险因素。
Objective Sentinel lymph node biopsy (SLNB) has been widely used in surgical treatment of breast cancer. Clinically, some metastatic lymph nodes are limited to sentinel lymph nodes. This study analyzed the influencing factors of non-sentinel lymph node (NSLN) metastasis in sentinel lymph node (SLN) -positive breast cancer patients to avoid unnecessary axillary lymph node dissection (ALND). Methods Retrospective analysis of clinicopathological data of 77 female breast cancer patients with positive SLND in SLNB from 2013 to 2015 in the Department of Breast Surgery, Liaocheng People’s Hospital, analyzed the influencing factors of NSLN metastasis. Results When the number of SIN was ≥ 4, univariate analysis showed that positive SLN≥2 (χ ~ 2 = 10.109, P = 0.01) and LuminalB genotype (χ ~ 2 = 6.442, P = 0.02) High risk of transfer. Logistic regression analysis showed that positive SLN≥2 was an independent risk factor for NSLN metastasis (OR = 207.833, 95% CI 1.430 ~ 30 201.980, P = 0.036). Conclusions Positive SLNs and molecular subtypes are risk factors for NSLN metastasis. Positive SLN≥2 are independent risk factors for NSLN metastasis.