不同分型浸润性乳腺癌与腋窝淋巴结转移的相关性

Correlation between different types of invasive breast cancer and axillary lymph node metastasis

目的:研究不同分型浸润性乳腺癌与腋窝淋巴结转移的相关性。方法:收集2013年1月—2015年1月于上海新华医院崇明分院接受乳腺癌手术治疗的102例患者。将所有受试者按照免疫组织化学及HER2荧光原位杂交结果的不同分为Luminal A型、Luminal B型、HER2阳性型及三阴性乳腺癌。比较不同分型乳腺癌患者的腋窝淋巴结转移情况、病理参数及预后情况。并以Logistic分析法明确乳腺癌患者预后不良的影响因素。结果:102例乳腺癌患者腋窝淋巴结转移率为34.65%,其中Luminal A型、Luminal B型、HER2阳性型及三阴性乳腺癌的腋窝淋巴结转移率分别为24.00%、41.46%、45.45%及14.29%。不同分型乳腺癌患者的腋窝淋巴结转移率差异无统计学意义(均P>0.05)。肿瘤直径≥5 cm的乳腺癌患者腋窝淋巴结转移率高于<5 cm的患者(P<0.05)。三阴性乳腺癌患者局部复发率高于其他分型乳腺癌患者,且HER2阳性型、三阴性乳腺癌患者的远处转移率均高于LuminalA型、LuminalB型,而三阴性乳腺癌患者存活率均低于其他分型乳腺癌患者(均P<0.05)。经Logistic分析可得:三阴性、腋窝淋巴结转移、局部复发均是乳腺癌患者预后不良的独立危险因素(均OR>1,P<0.05)。结论:LuminalB型及HER2过表达型乳腺癌患者的腋窝淋巴结转移风险差异不大,但三阴性乳腺癌患者预后相对较差,值得临床重点关注。

Objective: To study the correlation between different types of invasive breast cancer and axillary lymph node metastasis. Methods: From January 2013 to January 2015, 102 cases of breast cancer patients receiving surgical treatment in our hospital were selected. All subjects were divided into LuminalA type, LuminalB type, HER2 positive type and triple negative breast cancer according to the results of immunohistochemistry and HER2 fluorescence in situ hybridization. The axillary lymph node metastasis, pathological parameters and prognosis of different types of breast cancer were compared. Logistic analysis was used to determine the influencing factors of poor prognosis in breast cancer patients. Results: The axillary lymph node metastasis rate of 101 breast cancer patients was 34.65%, among which the rates of LuminalA type, LuminalB type, HER2 positive type and triple negative breast cancer were 24.00%, 41.46%, 45.45% and 14.29%, respectively. The axillary lymph node metastasis rate of patients with different types of breast cancer,difference was not significant(all P>0.05). The axillary lymph node metastasis rate of breast cancer patients with tumor pathological size ≥5 cm was higher than that of patients with pathological size < 5 cm(P<0.05). The local recurrence rate of patients with triple negative breast cancer was higher than that of other types of breast cancer, and the distant metastasis rate of patients with HER2 positive and triple negative breast cancer was higher than that of patients with LuminalA and LuminalB, while the survival rate of patients with triple negative breast cancer was lower than that of patients with other types of breast cancer(all P<0.05). Logistic analysis showed that three negative results, axillary lymph node metastasis and local recurrence were independent risk factors for poor prognosis in breast cancer patients(all OR>1, P<0.05). Conclusion: Patients with LuminalB type and HER2 overexpressed breast cancer of risk of axillary lymph node metastasis has not signifcant, and patients with triple negative breast cancer have a relatively poor prognosis. It is worthy of clinical attention.