乳腺黏液癌淋巴结转移的高危因素及其对预后的影响

Risk factors of lymph node metastasis in patients with mucinous breast cancer and its influence on prognosis

目的探讨乳腺黏液癌淋巴结转移的高危因素及其对预后的影响。方法收集183例乳腺黏液癌患者的临床病理资料及生存情况，采用Logistic回归模型分析与黏液癌淋巴结转移相关的，临床病理因素，并分析其预后。结果183例乳腺黏液癌患者中共35例（19．1％）出现淋巴结转移。单因素分析显示，肿瘤大小、组织学亚型、雌激素受体（ER）、人表皮生长因子受体2（HER-2）、分子分型与乳腺黏液癌淋巴结转移相关（P均〈0．05）。多因素分析显示，肿瘤大小他～4（P=0．044）、混合型（P=0．031）、非LuminalA型（P=0．000）是乳腺黏液癌淋巴结转移的独立高危因素。淋巴结转移与无转移患者的5年无病生存率分别是83．0％、97．4％（P〈0．05），5年总体生存率分别是88．5％、99．1％（P〈0．05）。结论乳腺黏液癌的淋巴结转移少，肿瘤大小〉2cm、混合型、非LuminalA型是其淋巴结转移的高危因素。淋巴结转移的乳腺黏液癌预后较差。

Objective To investigate the risk factors of lymph node metastasis and prognostic role in patients with mueinous breast cancer（MBC）. Methods The clinicopathological data and survival status of 183 patients with MBC were collected. Logistic regression analysis were performed to identify the relevance of clinicopathological features with lymph node metastasis in MBC, and the prognosis were analyzed. Results Lymph node metastases were found in 35 patients （ 19. 1% ） of all the patients. Univari ate analysis showed that tumor size, histologic subtypes, ER, HER-2, molecular subtypes were significantly correlated with lymph node metastasis in MBC （ P 〈 0. 05 ）. Tumor size T2 - 4 （ P = 0. 044）, mixed type （ P = 0. 031 ）, non-Luminal A type （ P = 0. 000） were the risk factors of lymph node metastasis in MBC via multivariate analysis. The 5-year disease-free survival （DFS） of patients with lymph node metastasis or not were 83.0% and 97.4% （P 〈0. 05） respectively, and the 5-year overall survival were 88.5% and 99. 1% （P 〈 0. 05 ） respectively. Conclusions The lymph node metastasis were rare in MBC. Tumor size T2 - 4, mixed type, non-Luminal A type were the risk factors of lymph node metastasis in MBC. The MBC with lymph node metastasis had poor prognosis.