原发性浸润性乳腺癌患者发生脉管浸润的相关危险因素分析

Analysis of risk factors for vascular infiltration in primary invasive breast cancer

目的探讨原发性浸润性乳腺癌患者发生脉管浸润的相关危险因素。方法采用多因素Logistic回归模型分析365例原发性浸润性乳腺癌患者发生脉管浸润的独立危险因素。结果365例原发性浸润性乳腺癌患者中,91例患者发生了脉管浸润。单因素分析结果显示,不同腋窝淋巴结转移数量、TNM分期、组织学分级、Ki-67表达水平和分子分型原发性浸润性乳腺癌患者的脉管浸润发生率比较,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,腋窝淋巴结转移数量﹥3个、TNM分期为Ⅲ期、分子分型为LuminalB型、分子分型为HER2阳性型、分子分型为三阴性均是原发性浸润性乳腺癌患者发生脉管浸润的独立危险因素(P﹤0.05)。结论腋窝淋巴结转移数量﹥3个、TNM分期为Ⅲ期、分子分型为LuminalB型、分子分型为HER2阳性型、分子分型为三阴性的原发性浸润性乳腺癌患者发生脉管浸润的风险较高,因此要对该部分患者重点关注,早发现、早治疗,降低脉管浸润的发生率。

Objective To explore the risk factors of the vascular infiltration in primary invasive breast cancer patients. Method Multivariate Logistic regression model was used to analyze the independent risk factors of vascular invasion in 365 patients with primary invasive breast cancer. Result Among the 365 cases with primary invasive breast cancer, vascular infiltration occurred in 91 patients. Univariate analysis showed that, there were statistically significant differences in the number of metastatic axillary lymph nodes, TNM stage, histological grade, Ki-67 expression level and molecular subtypes of primary invasive breast cancer patients(P<0.05). Multivariate Logistic regression analysis indicated that,the number of metastatic axillary lymph nodes >3, TNM stage Ⅲ, molecular subtype of Luminal B, molecular subtype of HER2-positive, and molecular subtype of triple-negative lesions were independent risk factors of vascular infiltration for patients with primary invasive breast cancer(P<0.05). Conclusion The risk of developing vascular infiltration would be higher in patients with more metastatic axillary lymph nodes, TNM stage Ⅲ, molecular subtype of Luminal B, HER2-positive and triple-negative lesions, which should be monitored closely as to reduce the incidence of lymphsvascular invasion.