期刊文献+

乳腺癌患者胸肌间淋巴结转移的影响因素及手术清扫 被引量:14

Factors influencing the metastasis of Rotter's lymph node and its surgical dissection in patients with breast cancer
下载PDF
导出
摘要 目的:分析乳腺癌患者胸肌间淋巴结(IPNs)的检出率、转移率及其影响因素,探讨胸肌间淋巴结清扫的意义和指征。方法:回顾性分析1 673例接受乳腺癌改良根治术并且胸肌间淋巴结单独送病理检查患者的病理临床资料,记录IPNs的检出率和转移情况,分析IPNs转移与肿瘤大小、腋窝淋巴结、临床分期、新辅助化疗、激素受体、Her-2表达以及乳腺癌分子亚型的关系。结果:本组病例IPNs检出率、IPNs总体转移率、腋窝淋巴结阳性者IPNs转移率分别为13.39%、4.3%和10.01%。IPNs转移率与腋窝淋巴结转移、肿瘤TNM分期之间具有显著相关性(P<0.05),但与激素受体状况、Her-2表达以及乳腺癌分子亚型之间未见相关(P>0.05);新辅助化疗并未降低肿瘤局部偏晚患者的IPNs转移率;IPNs转移者表现为肿瘤较大、腋窝淋巴结转移多、TNM分期较晚。结论:IPNs转移多见于肿瘤直径较大、腋窝淋巴结转移、TNM分期较晚、局部晚期以及适合新辅助化疗的乳腺癌患者,这些指征可能意味着需要常规进行IPNs的手术清扫和单独送检。 Objective:This study aims to analyze the occurrence rate, positive rate, and other related factors influencing interpec-toral lymph nodes (IPNs) in breast cancer patients. This work further aims to explore the significance and indications of the surgical dis-section of IPNs. Methods:Clinical and pathological data from 1673 breast cancer patients were retrospectively analyzed. All patients were subjected to modified radical mastectomy, and IPNs were pathologically examined. The occurrence rate and metastasis of IPNs were recorded, and the relationship between the IPN positive rate and tumor size, axillary nodes, clinical stages, neo-adjuvant chemo-therapy, hormone receptors, Her-2 expression, and molecular subtypes of breast carcinoma was determined. Results:The occurrence rate, overall metastasis rate, and the positive rate of IPNs in patients with axillary lymph node metastasis were 13.39%, 4.30%, and 10.01%, respectively. IPN metastasis was significantly correlated with axillary node metastasis and the tumor, node and metastasis (TNM) stage of tumors (P〈0.05). However, IPN metastasis was not significantly related with hormone receptor and Her-2 expressions. IPN metastasis rate may be unaffected by neo-adjuvant chemotherapy. Patients with IPNs metastasis were characterized by larger tu-mors, more positive axillary lymph nodes, and later TNM stages. Conclusion:IPN metastasis usually occurs in patients with larger tu-mors, more positive axillary lymph nodes, later TNM stages, as well as those with locally advanced cancer that meet the standard of neo-adjuvant chemotherapy. These indications suggest that the surgical dissection and pathological examination of IPNs should be rou-tinely performed.
出处 《中国肿瘤临床》 CAS CSCD 北大核心 2014年第8期518-521,共4页 Chinese Journal of Clinical Oncology
关键词 乳腺癌 改良根治术 胸肌间淋巴结 影响因素 breast cancer, modified radical mastectomy, interpectoral lymph node, influencing factors
  • 相关文献

参考文献15

二级参考文献83

  • 1仇爱峰,徐青,王庆庆.新辅助化疗对乳腺癌患者腋窝前哨淋巴结活检的影响[J].山东医药,2005,45(36):34-35. 被引量:8
  • 2龙飞,张斌,李爽.乳腺癌新辅助化疗后前哨淋巴结活检术的研究[J].中国实用外科杂志,2006,26(4):275-276. 被引量:18
  • 3耿振宏,张在兴.乳癌肌间淋巴结转移[J].滨州医学院学报,1996,19(5):495-496. 被引量:1
  • 4Oran I,MemisA,Ustun EE.Uitrasonographic detection of interpectoral(Rotter' s) node in involvement in breast cancer[J].J clin Uitrasound,1996,24(9):519-522.
  • 5Vrdoljak DV,Ramljak V,Muzina D,et al.Analysis of metastatic involvement of interpectoral (Rotter' s) lymph nodes relatedto tumor location,size,grade and hormone receptor status in breast cancer[J].Tumori,2005,91(2):177-181.
  • 6Komenaka IK,Bauer VP,Schnabel FR,et al.Interpectoral nodes as the initial site of recurrence in breast cancer[J].ArchSurg,2004,139(2):175-178.
  • 7Ellis IO,Gales M,Broughton N,et al.Pathological prognostic factors in breast cancer.Ⅱ.Histological type.relationship with survival in a large study with longterm follow- up[J].Histopathology,1992,20:479-489.
  • 8Chandawarkar RY,Shinde SR.Interpectoral nodes in carcinoma of breast:requiem or resurrection[J].J Surg Oncol,1996,62(3):158-161.
  • 9Komenaka IK,Bauer VP,Schnabel FR,et al.Interpectoral nodes as the initial site of recurrence in breast cancer[J].Arch Surg,2004,139(2):175-178.
  • 10Recht A,Gray R,Nancy E,et al.Locoregional Failure 10 Without Tamoxifen Without Irradiation:Experience of the Eastern Cooperative Oncology Group[J].J Clin,1999,17 (6):1689-1700.

共引文献40

同被引文献123

  • 1赵文生,黄安中,彭上清,刘景田,李成伟.保乳手术与改良根治术治疗早期乳腺癌的疗效对比[J].中国老年学杂志,2014,34(11):3005-3006. 被引量:69
  • 2欧阳涛,李金锋,王天峰,林本耀.淋巴结阳性乳腺癌腋窝清扫范围探讨[J].中华外科杂志,2005,43(5):298-300. 被引量:13
  • 3周鑫,杨家祥,朱宁生,刘晓渝,向前,江歌丽.乳腺癌胸肌间淋巴结转移的临床分析[J].肿瘤防治研究,2007,34(10):790-791. 被引量:4
  • 4Teh YC, Shaari NE, Taib NA, et al. Determinants of choice of surgery in asian patients with early breast cancer in a middle income country [J]. Asian Pac J Cancer Prey, 2014,15(7):3163-3167.
  • 5Jagsi R, Jiang J, Momoh AO, et al. Trends and variation in use of breast reconstruction in patients with breast cancer undergoing mastectomy in the United States[J]. J Clin Oncol, 2014,32(9):919- 926.
  • 6Testa A, Iannace C, Di Libero L. Strengths of early physical reha- bilitation programs in surgical breast cancer patients: results of a randomized controlled study[J].. Eur J Phys Rehabil Med, 2014,50 (3):275-284.
  • 7Nakagawa T, Sato T, Mori H, et al. A case of T4bN3c breast can- cer treated with modified radical mastectomy with immediate re- construction using a tissue expander after systemic chemotherapy [J]. Gan To Kagaku Ryoho, 2013,40(12):2354-2356.
  • 8Suzuki S, Sakurai K, Nagashima S, et al. The difficulty of choosing a treatment strategy for ductal carcinoma in situ of the breast de- tected by breast cancer screening-a case report[J]. Gan To Kagaku Ryoho, 2013,40(12):2408-2410.
  • 9Lu C, Xu H, Chen X, et ah Irradiation after surgery for breast can- cer patients with primary tumours and one to three positive axillary lymph nodes: yes or no[J]. Curr Oncol, 2013,20(6):585-592.
  • 10Chen D, Lai L, Duan C, et ah Conservative surgery plus axillary radiotherapy vs. modified radical mastectomy in patients with stage I breast cancer[J]. Clin Breast Cancer, 2014,14(1 ):10-13.

引证文献14

二级引证文献84

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部