乳腺癌患者腋窝淋巴结转移状态的预测

Prediction on the axillary lymph node metastasis for breast cancer patients

腋窝淋巴结转移状态是乳腺癌患者最重要的预后决定因素之一.联合临床查体及超声、钼钯、CT、MRI、PET-CT等影像学检查可以提高预测准确率,但仍存在较高的假阴性率.超声引导下细针穿刺腋窝淋巴结能有效提高术前诊断率.结合患者的临床病理特征,利用数学及统计学方法构建预测前哨或非前哨淋巴结转移状态的模型可以计算其转移风险,筛选出淋巴结转移风险低的患者使其避免腋窝手术是否安全仍需相关的临床试验验证.

Axillary lymph node status isone of the most important prognostic factors for the patients with breast cancer.Physical examination combining with ultrasound, mammography, CT, MRI and PET-CT can improve the predictive efficiency, but there is still high false negative rate.Ultrasound-guided fine-needle aspiration for axillary lymph node can improve preoperative diagnostic rate effectively.Using mathematical and statistical methods, building models for predicting sentinel lymph node or non-sentinel lymph node status with clinicopathological features helps to calculate the risk of lymph node involvement.Whether screening out patients with low risk of lymph node involvement avoiding axillary surgery is safe or not is still to be evaluated by relevant clinical trials.