放疗后上肢乳腺癌相关淋巴水肿的危险因素分析

Analysis of Risk Factors of Upper Limb Breast Cancer Related Lymphedema after Radiotherapy

目的对放疗后上肢乳腺癌相关淋巴水肿(BCRL)的调查及危险因素分析。方法选取2012年2月—2016年6月手术治疗后行放疗的乳腺癌168例作为研究对象,记录患者年龄、体重指数(BMI)、发病部位、TNM分期、腋窝淋巴清扫数量、手术方式、是否化疗、是否进行上肢锻炼等资料,调查患者放疗后上肢BCRL的发生情况以及分析其危险因素。结果 168例行乳腺癌放疗的患者中发生BCRL 72例(42.86%)。多因素Logistic回归分析结果显示,BMI≥25 kg/m2、腋窝淋巴结清扫数量≥14枚是乳腺癌放疗后上肢BCRL发生的危险因素,而进行上肢锻炼是保护因素(P<0.05)。结论乳腺癌患者放疗后上肢BCRL的发生率较高,BMI、腋窝淋巴结清扫数量及上肢锻炼与BCRL发生的有关。

Objective To investigate and analyze risk factors of upper limb breast cancer related lymphedema(BCRL)after radiotherapy.Methods A total of 168 breast cancer patients undergoing postoperative radiotherapy during February 2012 and June 2016 were recruited in this study,and patients'conditions such as age,body mass index(BMI),lesion location,TNM staging,dissection number of axillary lymph node,surgery methods,whether or not having chemotherapy and upper limb exercise were recorded,and incidence rate and risk factors of upper limb BCRL were investigated.Results Among the 168 breast cancer patients undergoing postoperative radiotherapy,72 patients(42.86%)had BCRL.Multivariate Logistic regression analysis showed that BMI≥25 kg/m 2,dissection number of axillary lymph node≥14 were risk factors of incidence,while upper limb exercise was protective factors of upper limb BCRL after radiotherapy(P<0.05).Conclusion Patients with breast cancer after radiotherapy have high incidence rate of upper limb BCRL,and BMI,dissection number of axillary lymph node and upper limb exercise are related to BCRL pathogenesy.