早期乳腺癌腋淋巴结转移的多因素分析

Study on the multiple factors of axillary lymph node metastases in patients with early breast cancer

目的探讨早期乳腺癌腋淋巴结转移(ALNM)的相关因素,并对阴性腋淋巴结行角蛋白19(CK19)检测以发现微转移癌。方法收集乳腺癌病例138例,建立数据库,用Logistic回归进行单因素和多因素分析,并对有意义的指标进行相关分析,对40例患者441枚阴性腋淋巴结再切片,用CK19行免疫组织化学染色。结果多因素分析显示肿瘤大小、肿瘤部位、癌抗原153(CA153)、人类表皮生长因子受体-2(HER2)4个指标进入Logistic回归方程,40例患者中有3例患者的腋窝淋巴结CK19免疫组织化学染色阳性。结论肿瘤大小、肿瘤部位、CA153和HER2为乳腺癌患者ALNM的高危因素;CK19免疫组织化学染色可发现乳腺癌腋淋巴结微转移癌。

Objective： To investigate the factors related with axillary lymph node metastases （ALNM） of early breast cancer and to further evaluate the axillary lymph nodes （ALNs） that were tumor negative in conventional HE staining using immunohistochemical stains for CK19 antibody. Methods： 138 breast cancer patients were collected to set up the database, single and multi-factors logistic regression and then correlation analysis were used to evaluate the factors concerned. The 441 ALNs of 40 cases that were tumor negative in conventional HE staining were further evaluated using immunohistochemical stains for CKI9 antibody. Results：Multi-factors logistic regression analysis showed that 4 factors including diameter of primary tumor, location of tumor, HER2, CA153 entered the logistic equation. There were 3 cases whose ALNs were reactive to immunostain for CK19 antibody among 40 cases whose ALNs were negative for HE stain. Conclusion：Diameter of primary tumor, Location of tumor, HER2, CA153 were the risk factors of ALNM. Immunohistochemical staining can increase the detection rate of lymph node micrometastases.