乳腺导管原位癌伴微小浸润腋窝前哨淋巴结转移的危险因素分析

Analysis of Risk Factors of Breast Ductal Carcinoma in Situ with Minimal Invasive Axillary Sentinel Lymph Node Metastasis

目的:探讨乳腺导管原位癌伴微小浸润腋窝前哨淋巴结转移的危险因素.方法:回顾性分析2016年5月-2019年5月在本院乳腺外科接受治疗的200例乳腺导管原位癌伴微小浸润患者的资料.按照患者是否出现腋窝前哨淋巴结转移分为对照组183例和病例组17例.通过单因素与多因素分析,筛选出乳腺导管原位癌伴微小浸润患者出现腋窝前哨淋巴结转移的独立影响因素.结果:200例患者中有17例出现腋窝前淋巴结转移,转移率为8.5%.两组年龄、肿瘤直径、组织学分级比较,差异均有统计学意义(P<0.05).logistic多因素回归分析结果显示,肿瘤直径>3 cm、组织学分级为高级均为乳腺导管原位癌伴微小浸润患者出现腋窝前哨淋巴结转移的独立危险因素(P<0.05).结论:肿瘤直径较大、癌细胞的分化程度低为乳腺导管原位癌伴微小浸润患者出现腋窝前哨淋巴结转移的独立危险因素,对于该种患者应积极的完成准确的前哨淋巴结组织活检.

Objective:To explore the risk factors of breast ductal carcinoma in situ with minimal invasive axillary sentinel lymph node metastasis.Method:The retrospective analysis of 200 patients with ductal carcinoma in situ with minimal invasion who were treated in the breast surgery department of our hospital from May 2016 to May 2019 were performed.According to the presence or absence of axillary sentinel lymph node metastasis,the patients were divided into control group 183 cases and case group 17 cases.Independent factors influencing axillary sentinel lymph node metastasis in patients with ductal carcinoma in situ with minimal invasive were identified by univariate and multivariate analyses.Result:17 of the 200 patients had axillary lymph node metastasis,the rate of metastasis was 8.5%.The age,tumor diameter and histological grade of the two groups were compared,the differences were statistically significant(P<0.05).Logistic multivariate regression analysis showed that tumor diameter of>3 cm and histological grade of advanced were independent risk factors for axillary sentinel lymph node metastasis in patients with ductal carcinoma in situ with minimal invasion(P<0.05).Conclusion:Large tumor diameter and low differentiation of cancer cells are independent risk factors for axillary sentinel lymph node metastasis in patients with ductal carcinoma in situ(DCIS)accompanied by minimal invasion,accurate sentinel lymph node biopsy should be performed actively in these patients.