乳腺癌患者腋淋巴结转移临床病理特征及其预后影响因素分析

Clinico-pathological features and influencing factors of prognosis on axillary lymph node metastasis in patients with breast cancer

目的:分析液淋巴结阳性乳腺癌患者临床病理特征及预后的影响因素。方法:收集2010年3月~2012年12月我院收治的286例ALN阳性的乳腺癌患者临床病理资料及随访资料,应用Kaplan-Meier法、Cox比例模型分析影响患者预后的危险因素。结果:286例患者随访47~136个月,中位随访时间为69个月,全组5年无病生存率为83.57%,5年总生存率为89.16%。单因素分析显示,年龄、组织学分级、转移性ALN数目、淋巴结转移率(LNR)与5年无病生存率有关;年龄、组织学分级、转移性ALN数目、LNR≥0.25、ER阴性、PR阴性与5年总生存率有关。Cox多因素分析显示,年龄≤40岁、转移性ALN数目>3个、LNR≥0.25是ALN阳性的乳腺癌患者5年无病生存的独立危险因素;年龄≤40岁、转移性ALN数目>3个、LNR≥0.25、ER阴性、PR阴性均为ALN阳性的乳腺癌患者5年总生存的独立危险因素。结论:发病年龄、转移性ALN数目、ALN及ER、PR状态均与ALN阳性的乳腺癌患者预后相关。

Objective To analyze the clinico-pathological features and influencing factors of prognosis of breast cancer patients with positive axillary lymph node(ALN).Methods The clinico-pathological data and follow-up of 286 breast cancer patients with positive ALN admitted to the hospital from March 2010 to December 2012 were collected.Kaplan-Meier method and Cox proportional model were used to analyze the risk factors affecting the prognosis of patients.Results 286 patients were followed up for 47 to 136 months,The median follow-up time was 69 months.The 5-year disease-free survival rate and the 5-year overall survival rate were 83.57%and 89.16%,respectively.Univariate analysis showed that age,histological grade,number of metastatic ALN and metastasis rate of lymph node(LNR)were associated with 5-year disease-free survival rate.Age,histological grade,number of metastatic ALN,LNR greater than or equaling to 0.25,negative ER and negative PR were associated with 5-year overall survival rate.Cox multivariate analysis showed that age not greater than 40 years,metastatic ALN number greater than 3,LNR not less than 0.25 were independent risk factors for 5-year disease-free survival rate in breast cancer patients with positive ALN.Age not greater than 40 years old,the number of metastasis ALN greater than 3,LNR not less than 0.25,negative ER and negative PR were all independent risk factors for 5-year overall survival rate in breast cancer patients with positive ALN.Conclusions Age of onset,number of metastatic ALN,ALN,ER and PR status are all associated with prognosis in breast cancer patients with positive ALN.