局部晚期乳腺癌患者腋窝淋巴结转移范围的影响因素分析

Influencing factors of axillary lymph node metastasis in patients with locally advanced breast cancer

目的:研究局部晚期乳腺癌患者腋窝淋巴结转移程度的影响因素。方法:回顾性收集我院2008年4月到2018年4月腋窝淋巴结转移≥4枚的233例乳腺癌患者的临床病理资料,比较腋窝淋巴转移N_2组(141例)和N_3组(92例)患者间的年龄、分子分型[Luminal A分子分型、人表皮生长因子受体2(human epidermal growth factor receptor2,HER-2)阳性,三阴性]、肿瘤大小、组织学分级、雌激素、孕激素受体表达、HER-2表达及Ki-67表达的差异。结果:N2组患者中肿瘤大小为T_1、T_2、T_3、T_4的百分比分别为46.1%、49.6%、2.8%、1.4%;N_3患者中肿瘤大小为T_1、T_2、T_3、T_4的百分比分别为27.2%、58.7%、13.0%、1.1%,与N_2组比较,N_3组患者的肿瘤直径更大(P=0.002)。而N_2组与N_3组患者在年龄、分子分型、组织学分级及雌激素受体、孕激素受体、HER-2、Ki-67表达方面差异均无统计学意义(P>0.05)。结论:局部晚期乳腺癌淋巴结转移范围与肿瘤大小(T分期)显著相关,而与乳腺癌患者的年龄、分子分型、组织学分级及雌激素受体、孕激素受体、HER-2、Ki-67表达无关。

Objective: To investigate the influencing factors of axillary lymph node metastasis in patients with locally advanced breast cancer. Methods: The clinical pathological data of 233 locally advanced breast cancer patients with at least 4 axillary lymph nodes metastasis from April, 2008 to April, 2018 in our hospital were collected retrospectively. The age, molecular type(luminal A/luminal B, HER-2 positive/negative, triple negative), tumor diameter, histological grade and the expression of ER/PR, HER-2, Ki-67 were compared between patients with N2 and N3 axillary lymph node metastasis. Results: Of the 233 locally advanced breast cancer patients, 141 patients were in Group N2 while 92 patients were in Group N3. The proportions of T1, T2, T3 and T4 in N2 group were 46.1%, 49.6%, 2.8% and 1.4%, respectively, whereas that in N3 group were 27.2%, 58.7%, 13.0% and 1.1%, respectively. The diameter of tumor was larger in N3 group than in N2 group(P=0.002). There was no statistical difference between Group N2 and N3 in terms of age, molecular type, histological grade, ER/PR expression, HER-2 expression and Ki-67 expression(P>0.05). Conclusions: In locally advanced breast cancer,the number of axillary lymph nodes metastasis is correlated significantly with the diameter of tumor(T stage). while no correlations with age, molecular type, histological grade, ER/PR expression, HER-2 expression and Ki-67 expression are found.