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目的探讨乳腺癌患者胸肌间淋巴结(IPNs)转移的影响因素及IPNs清扫的意义。方法回顾性分析2002年1月至2015年1月1 437例接受乳腺癌改良根治术且IPNs进行病理检查患者的临床资料,记录IPNs的检出率与转移情况,并分析IPNs阳性率与TNM分期、腋窝淋巴结转移、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体(Her)-2以及分子亚型之间的相关性。结果 IPNs的检出率、转移率以及腋窝淋巴结阳性患者IPNs转移率分别为13.64%、4.11%与9.62%。患者TNM分期越晚,IPNs转移率越高,差异具有统计学意义(P<0.01)。腋窝淋巴结转移个数越多,IPNs转移率越高,差异具有统计学意义(P<0.01)。腋窝淋巴结转移个数是IPNs转移率的独立影响因素。是否进行新辅助化疗对IPNs阳性率无显著性影响(P>0.05)。结论对于TNM分期较晚、腋窝淋巴结转移较多的患者,需要进行常规IPNs清扫,以减少复发与转移的发生,提高患者的存活率与生存质量。
Objective To investigate the influencing factors of the metastasis of pectoral lymph nodes (IPNs) in breast cancer patients and the significance of IPNs dissection. Methods The clinical data of 1 437 patients with modified radical mastectomy and IPNs pathological examination from January 2002 to January 2015 were retrospectively analyzed. The detection rate and metastasis of IPNs were recorded. The positive rates of IPNs and TNM stage were analyzed. , Axillary lymph node metastasis, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (Her) -2 and molecular subtypes. Results The detection rate of IPNs, the metastasis rate and the IPNs metastasis rate in patients with axillary lymph node were 13.64%, 4.11% and 9.62% respectively. The later TNM staging, the higher the IPNs metastasis rate, the difference was statistically significant (P <0.01). The more axillary lymph node metastasis, the higher the IPNs metastasis rate, the difference was statistically significant (P <0.01). The number of axillary lymph node metastases is an independent factor of IPNs metastasis rate. Neoadjuvant chemotherapy had no significant effect on the positive rate of IPNs (P> 0.05). Conclusions For patients with late TNM stage and more axillary lymph node metastases, routine IPNs need to be performed to reduce the incidence of recurrence and metastasis and improve the survival rate and quality of life.