腋窝淋巴结结外转移对乳腺癌妇女生存状况影响的研究

Effect of axillary lymph node metastasis on survival of women with breast cancer

目的探讨乳腺癌妇女的腋窝淋巴结结外转移情况对其生存状况影响。方法回顾性分析2016年10月-2018年12月于郑州大学第三附属医院接受治疗并有完整的随访记录的原发性浸润性乳腺癌老年患者106例,采用单因素分析患者年龄、肿瘤大小、ER状态、PR状态、组织学分化、淋巴结阳性数、淋巴结转移水平、腋窝淋巴结转移情况与的无复发生存率(RFS)以及总体生存率(OS)等预后情况相关性。采用多因素Cox比例风险模型,分析单因素分析中具有统计学意义的相关因素与RFS、OS的相关性,判断腋窝淋巴结结外转移对患者预后生存状况的影响。采用Kaplan-Meier生存分析法,分析单纯腋窝淋巴结患者和腋窝淋巴结转移伴随腋窝淋巴结结外转移患者的RFS、OS差异。结果单因素分析结果显示,肿瘤大小、淋巴结转移阳性数、淋巴结转移水平是腋窝淋巴结结外转移水平的相关因素。多因素分析显示,腋窝淋巴结结外转移、淋巴结转移及淋巴结阳性是RFS、OS的相关性的危险因素。Kaplan-Meier生存分析显示,腋窝淋巴结转移伴随腋窝淋巴结结外转移患者的RFS、OS均低于单纯腋窝淋巴结患者,差异具有统计学意义(P<0.05)。结论腋窝淋巴结结外转移是乳腺癌患者预后生存期的危险因素,可作为乳腺癌患者预后状况的判断指标。

Objective To investigate the effect of axillary lymph node metastasis on the survival of breast cancer patients.Methods A retrospective analysis in October 2016 to December 2018 in our hospital for treatment and follow-up of complete records of 106 cases of elderly patients with primary invasive breast cancer,using single factor analysis state of patient age,tumor size,ER and PR status,histological differentiation,lymph node positive number,lymph node metastasis level,axillary lymph node metastasis with relapse-free survival(RFS)and overall survival(OS)and prognosis.Multi-factor Cox proportional hazard model was adopted to analyze the correlation between statistically significant correlation factors in single-factor analysis and RFS and OS,and to determine the influence of axillary lymph node metastasis on prognosis and survival of patients.Kaplan-meier survival analysis was used to analyze the differences in RFS and OS between patients with axillary lymph node metastasis alone and patients with axillary lymph node metastasis accompanied by axillary lymph node metastasis.Results Single-factor analysis showed that tumor size,positive number of lymph node metastasis,and lymph node metastasis level were correlated with the level of axillary lymph node metastasis.Multivariate analysis showed that axillary lymph node metastasis,lymph node metastasis and lymph node positive were risk factors for correlation of RFS and OS.Kaplan-meier survival analysis showed that RFS and OS of patients with axillary lymph node metastasis accompanied by axillary lymph node metastasis were lower than those of patients with axillary lymph node metastasis alone,and the difference was statistically significant(P<0.05).Conclusion Axillary lymph node metastasis is a risk factor for survival of breast cancer patients,and can be used as a prognostic indicator for breast cancer patients.