前哨淋巴结阳性乳腺癌患者病理特征与非前哨淋巴结转移的关系

Correlation between clinicopathologic characteristis and non-sentinel lymph node metastasis in breast cancer patients with positive sentinel lymph node

目的探讨1~2枚前哨淋巴结阳性临床早期乳腺癌中能引起非前哨淋巴结转移的临床病理因素。方法收集101例相关乳腺癌患者的临床病理资料,对非前哨淋巴结转移的状态与临床病理参数的关系进行统计学分析。结果单因素分析提示,患者的年龄、肿块的直径、肿瘤的位置、ER、PR及Ki-67的表达等与非前哨淋巴结的转移无关(P>0.05)。而Her-2的表达,脉管内浸润,周围神经浸润,前哨淋巴结包膜外侵犯及转移前哨淋巴结的直径与非前哨淋巴结的转移密切相关(P<0.05)。多因素分析提示Her-2阳性表达,脉管内浸润,周围神经浸润,前哨淋巴结包膜外侵犯及转移前哨淋巴结的直径>10.6 mm是非前哨淋巴结转移的独立危险因素。结论 Her-2阳性表达,脉管内浸润,周围神经浸润,前哨淋巴结包膜外侵犯及转移前哨淋巴结的直径>10.6 mm是预测非前哨淋巴结转移的重要临床病理因素。

Objective The purpose of this study was to determine the risk factors that caused non-sentinel lymph nodes(nonSLNs) metastasis by considering the clinicopathological characteristics of patients who have 1-2 sentinel lymph node(SLN) metastasis in the clinical early stage(cT1-2 N0) breast cancer. Methods The demographic and clinicopathological characteristics of 75 patients were recorded retrospectively. The relationship between nonSLNs status and the clinicopathological characteristics of these patients was analyzed. Results The univariate analysis suggested that the age,tumor size,tumor location,ER,PR,and Ki-67 expression were not related to non-sentinel lymph node metastasis(P >0.05). However,the HER2 positivity,mSLN diameter,Vascular invasion(VI),Perineural invasion(PNI),and SLN Extra Nodal Extension(ENE) were found to be related to nonsentinel lymph node metastasis(P<0.05). The multivariate analysis indicated indicated that independent predictors for nonSLN metastasis development include HER2 positivity,PNI,mSLN diameter >10.6 mm,and ENE. Conclusion The HER2 positivity,ENE,PNI,and mSLN diameter >10.6 mm were found to be an important clinicopathological factor predicting nonSLN metastasis development,which will provide basis for making breast cancer surgery more precise.