预测乳腺癌非前哨淋巴结转移的临床意义

• 作 者: 张涛 张保宁 杨红鹰 孙耘田 刘琳 陈盛祖3
• 机 构: 中国协和医科大学中国医学科学院肿瘤医院腹部外科,中国协和医科大学中国医学科学院肿瘤医院腹部外科,中国协和医科大学中国医学科学院肿瘤医院病理科,中国协和医科大学中国医学科学院肿瘤医院病理科,中国协和医科
• 出 处: 肿瘤防治研究
• 发表日期: 2005年05期
• 关键词: 乳腺癌 腋窝淋巴结 腋窝 非前哨淋巴结 应用统计软件 脉管浸润 原发肿瘤 多因素分析 前哨淋巴结 浸润性导管癌

目的寻找与乳腺癌非前哨淋巴结(sentinellymphnode,SLN)转移相关的指标,预测非SLN是否有转移,避免对腋窝淋巴结无转移的患者进行腋窝清扫。方法回顾性分析从1999年5月到2004年2月完成的116例乳腺癌SLN活检病例,应用统计软件SPSS10.0对10种临床因素进行单因素和多因素分析,研究哪些因素与非SLN转移相关。结果原发肿瘤大于2cm,脉管浸润,cerbB2(+)这3个因素与非SLN转移相关,具有其中一个因素时,非SLN转移机率为91%～95%,具有其中两个因素时为94%～100%,三个因素均具有时为100%。结论非SLN转移的预测和SLN活检相结合,可以使转移仅局限于SLN的患者免除腋窝清扫,使治疗更加有的放矢。

OBJECTIVE: To find out the indicators related to the metastatic status of sentinellymphnode (SLN) in breast cancer and predict the metastasis of non-SLN to avoid axillary dissection in patients with axillary lymph nodes without metastasis. Methods One hundred and sixteen SLN biopsies from May 1999 to February 2004 were retrospectively analyzed. Univariate and multivariate analysis of 10 clinical factors were performed using statistical software SPSS10.0 to investigate which factors were associated with non-SLN metastasis Related. Results Primary tumor was more than 2 cm, vascular invasion and cerbB2 (+) were associated with non-SLN metastasis. With one of the factors, the non-SLN metastasis rate was 91% -95%, with 94% of the two factors % ~ 100%, all three have a time of 100%. Conclusion The combination of predicting non-SLN metastasis and SLN biopsy can eliminate the axillary dissection in patients with metastasis limited to SLN and make the treatment more targeted.