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目的探讨乳腺癌腋窝淋巴结转移的相关因素,为临床诊治及预后评估提供参考依据。方法选取1993年1月至2013年12月间收治经临床病理确诊乳腺癌患者104例,其中腋窝淋巴结转移48例,分析肿瘤大小、粉刺样坏死、核分裂数与腋窝淋巴结转移和分级的关系。结果乳腺癌发病的高峰年龄在40~50岁之间。腋窝淋巴结转移率随肿瘤增大而增高,肿瘤≤2 cm的腋窝淋巴结转移率为25.7%,2.1~5 cm者为50.0%,>5 cm者为84.6%,差异有统计学意义(P<0.05)。随肿瘤组织学分级的增高,出现粉刺样坏死的肿瘤也逐渐增加,但差异无统计学意义(P>0.05)。腋窝淋巴结转移患者的粉刺样坏死发生率(52.1%)高于未转移患者(51.8%),但差异无统计学意义(P=0.951)。细胞核分裂像≥10个组比0~9个组的患者发生腋窝淋巴结转移的数量明显增加,差异有统计学意义(P=0.010)。结论乳腺癌的肿瘤大小、核分裂数与腋窝淋巴结转移的密切相关,可以作为预测乳腺癌患者发生腋窝淋巴结转移的高危险因素。
Objective To investigate the related factors of axillary lymph node metastasis in breast cancer and provide reference for clinical diagnosis and prognosis evaluation. Methods From January 1993 to December 2013, 104 cases of breast cancer were diagnosed clinically and pathologically, including 48 cases of axillary lymph node metastasis. The relationship between tumor size, acne-like necrosis, mitosis and axillary lymph node metastasis and grading was analyzed. Results The peak incidence of breast cancer in the 40 to 50 years old. The rate of axillary lymph node metastasis increased with the increase of tumor size. The rate of axillary lymph node metastasis was 25.7% in 2 cm, 50.0% in 2.1 ~ 5 cm and 84.6% in> 5 cm (P <0.05) ). Tumor histological grade increased with acne-like necrosis of the tumor also increased gradually, but the difference was not statistically significant (P> 0.05). The incidence of acne-like necrosis in patients with axillary lymph node metastasis (52.1%) was higher than that in non-metastatic patients (51.8%), but the difference was not statistically significant (P = 0.951). The number of axillary lymph node metastases in patients with mitotic karyon ≥10 groups was significantly higher than that in patients with 0-9 groups (P = 0.010). Conclusion The close relationship between tumor size and mitotic number of breast cancer and axillary lymph node metastasis may be a high risk factor for predicting axillary lymph node metastasis in patients with breast cancer.