摘要
目的评价以淋巴结转移数（positivelymphnodes，PLN）、淋巴结转移率（1ymphnoderatio，LNR）和以淋巴结LODDS值（10goddsofpositivelymphnodes，LODDS）为基础N分期、rN分期、LODDS分期三种不同分期方法对乳腺癌患者生存和预后的预测价值。方法对472例原发性乳腺癌患者采用Kaplan-Metier单因素分析、COX回归进行多因素生存分析，比较三种分期方法的hazardratio（HR）值。结果当术中清扫淋巴结数〉10枚时，rN分期和LODDS分期中各期5年生存率差异有统计学意义（P〈0．05），而N分期中NO期与N1期差异无统计学意义。单因素分析显示：年龄、肿瘤大小、人表皮生长因子受体（humanepithelialgrowthfactorreceptor，HER2）状态、雌激素受体（estrogenreceptor，ER）状态和清扫淋巴结总数、N分期、州分期、LODDS分期与总生存期（overailsurvival，OS）相关（均P〈0．05）。COX多因素分析显示：rN分期和LODDS分期比N分期具有更高的HR值（分别为5．495，4．662，2．722）。结论rN分期和LODDS分期对原发性乳腺癌患者的预后预测结果优于N分期。
Objective To evaluate the prognostic value of three different staging system based on positive lymph nodes, lymph node ratio and log odds of positive lymph nodes in breast carcinoma. Methods In 472 breast carcinoma patients, survival analysis was performed with Kaplan-Merier and COX regression model, the hazard ratio （HR） of the three staging system were compared. Results When more than 10 lymph nodes were dissected in the operation, there was statistical differences in survival among the staging systems based on lymph node ratio and log odds of positive lymph nodes （ P 〈 0. 05 ）, while the prognosis was highly homologous between the staging systems based on positive lymph nodes in stage NO and N1. Univariate analysis showed age, tumor size, Her2 status, estrogen receptor status and the total lymph nodes dissected were related to overall survival （ all P 〈 0. 05 ）. COX multivariate analysis showed that the staging system based on lymph node ratio （ 5. 495 ） and log odds of positive lymph nodes （4. 662） had the higher HR than the N staging system（2. 722）. Conclusions Compared with the number of involved lymph nodes, the staging system based on lymph node ratio and log odds of positive lymph nodes were superior to the staging system based on positive lymph nodes for prognostic assessment of breast carcinoma.
出处
《中华普通外科杂志》
CSCD
北大核心
2014年第1期35-39,共5页
Chinese Journal of General Surgery
关键词
乳腺肿瘤
预后
淋巴转移
Breast neoplasms
Prognosis
Lymphatic metastasis
