乳腺癌低负荷前哨淋巴结阳性对非前哨淋巴结转移的预测分析

Status of the non-sentinel lymph node metastasis in breast cancer patients with small number of positive sentinel lymph node

目的探讨前哨淋巴结（sentinel lymphnode，SLN）阳性≤2个乳腺癌非前哨淋巴结（non—sen—tinellymphnode．NSLN）状态及其影响因素。方法回顾性分析88例SLN阳性≤2个的乳腺癌病例资料，分析NSLN状态相关影响因素。结果88例病例资料纳入分析，8例NSLN出现转移（9．09％），方差分析显示肿瘤分期（P-0．046）、组织学分级（P=0．014）、ER状态（P=0．009）在NSLN阳性和阴性2组中分布存在差异，Logistic多因素分析显示组织学分级是NSLN状态的独立影响因素（P=0．016，OR=1．150，95％C1=0．598—7．740）。SLN微转移18例（20．45％），宏转移70例（79．54％），SLN假阴性率10．23％。中位随访时间11个月，无复发、转移、死亡病例。结论低负荷SLN阳性的乳腺癌患者，NSLN转移率较低，NSLN转移受肿瘤分期、组织学分级、ER表达情况等因素影响。

Objective To explore the risk factors and metastasis of non-sentinel lymph node （NSLN） in breast cancer patients with sentinel lymph node metastasis ≤ 2. Methods 88 cases of breast cancer with sentinel lymph node metastasis≤2 were retrospectively analyzed. Factors influencing the status of NSLN were studied. Results 8 cases （9.09%） had NSLN metastasis. Variance analysis showed that tumor stage（P=0.014）, histological grade（P=0.014） and ER statuts（P=-0.009） were correlated with NSLN metastasis. Logistic analysis showed that only histological grade was the independent predictor for NSLN metastasis （P=0.016,OR=1.150,95% CI=0.598- 7.740）.18 eases had micro-metastasis of sentinel lymph node and 70 cases had macro-metastasis of sentinel lymph node. The ratio of false negative SLN was 10.23%. The mean follow-up time was 11 months. There was no case of recurrence, metastasis or death. Conclusions The metastasis rate of NSLN is relatively low in breast cancer patients with small number of positive SLNs. NSLN metastasis is related to tumor stage, histological grade, and ER expression.