阳性淋巴结比率对腋窝淋巴结受累乳腺癌患者总生存率的影响

Positive-exampled rate (PER) predicts overall survival in patients with axillary lymph node-positive breast cancer

目的研究腋窝淋巴结阳性乳腺癌患者,阳性淋巴结比率(positive-exampled rate,PER)对总生存率(overall survival,OS)的影响。方法回顾性分析术后病理证实腋窝淋巴结阳性的原发乳腺癌患者752例,收集患者的临床病例资料如年龄、月经状态、癌家族史、原发肿瘤直径、阳性淋巴结数、切检淋巴结数、腋尖淋巴结状态、PER、结外浸润(extracapsular extension,ECE)、雌激素和孕激素受体(estrogen-progesterone receptor,ER-PR)、术后化疗、术后放疗及局部区域复发率(locoregional recurrence rate,LRR),通过单因素和多因素分析比较上述临床病理因素对乳腺癌患者OS的影响。结果单因素分析提示,月经状态(P=0.006)、肿瘤直径、阳性淋巴结数、切检淋巴结数、PER、腋尖淋巴结、ECE、术后化疗、术后放疗和LRR(P值均<0.001)对腋窝淋巴结阳性乳腺癌患者OS的影响具有统计学意义。多因素分析提示,肿瘤直径、术后化疗、术后放疗、LRR和PER(P值均<0.05)是独立的预后影响因素。结论 PER是影响腋窝淋巴结阳性乳腺癌患者OS的独立预后指标。

Objective To evaluate the impact of positive-exampled rate（PER） on overall survival（OS） in patients with axillary lymph node-positive breast cancer.Methods The clinical records of 752 breast cancer patients with pathologically positive lymph nodes treated with surgical therapy were retrospectively reviewed.The data collected included age,menopaus,family history of cancer,tumor size,the number of positive lymph nodes,the number of excised nodes,apical lymph node,PER,extracapsular extension（ECE）,estrogen-progesterone receptor（ER-PR）,post-operative chemotherapy,post-operative radiotherapy and locoregional recurrence rate（LRR）.Study parameters were compared at the univariate and multivariate levels for their effects on OS.Results On univariate analysis,menopaus（P=0.006）,tumor size,the number of positive lymph nodes,the number of excised nodes,apical lymph node,PER,ECE,post-operative chemotherapy,post-operative radiotherapy and LRR（P〈0.001） were significant predictors of OS.On multivariate analysis,tumor size,PER,post-operative chemotherapy,post-operative radiotherapy and LRR remained independent predictors of OS（P〈0.05）.Conclusion PER is found to be a significant prognostic factor for OS.