乳腺癌腋窝淋巴结转移的影响因素分析

Analysis of influencing factors of axillary lymph node metastasis in breast cancer

目的探讨与乳腺浸润性癌腋窝淋巴结转移相关的临床病理特征,为术前预测乳腺癌腋窝淋巴结转移提供参考因素。方法回顾性分析2019年12月至2021年3月大连市妇女儿童医疗中心(集团)体育新城院区收治的70例乳腺癌患者的临床资料,收集患者年龄、肿瘤大小、病理分型、分子分型、病理分级、原发肿瘤灶数、微乳头结构及脉管浸润与否的信息。通过多因素分析影响腋窝淋巴结转移的危险因素。结果70例乳腺癌患者中,发生腋窝淋巴结转移29例,未转移41例。转移组与未转移组的肿瘤大小及脉管浸润与否比较,差异有统计学意义(P<0.05),而两组的年龄、病理分型、分子分型、病理分级、原发肿瘤灶数及是否伴有微乳头结构比较,差异无统计学意义(P>0.05)。多因素分析结果显示,肿瘤大小≥3.5 cm(β=1.829,OR=6.226,P=0.021,95%CI=1.315~29.490)及脉管浸润(β=2.578,OR=13.171,P<0.001,95%CI=3.861~44.937)是影响腋窝淋巴结转移的独立危险因素。结论肿瘤大小(≥3.5 cm)及脉管浸润是乳腺癌腋窝淋巴结转移的独立危险因素。临床可针对危险因素实现乳腺癌患者的精准化治疗。

Objective To investigate the clinicopathological features associated with axillary lymph node metastasis in invasive breast cancer,and to provide reference factors for preoperative prediction of axillary lymph node metastasis in breast cancer.Methods The clinical data of 70 patients with invasive breast cancer admitted to Dalian Women and Children Medical Center(Group)Sports New Town Campus from December 2019 to March 2021 were retrospectively analyzed.The information of patients′age,tumor size,pathological type,molecular type,pathological grade,number of primary tumor foci,micropapillary structure and vascular invasion were collected.The risk factors for axillary lymph node metastasis were analyzed by multivariate analysis.Results Among 70 patients with breast invasive cancer,29 cases had axillary lymph node metastasis and 41 cases had no metastasis.There were statistically significant differences in tumor size and vascular invasion between the metastatic group and the non-metastatic group(P<0.05).There were no significant differences in age,pathological type,molecular type,pathological grade,number of primary tumor foci and whether accompanied by micropapillary structure between the two groups(P>0.05).Multivariate analysis showed that the tumor size was≥3.5 cm(β=1.829,OR=6.226,P=0.021,95%CI=1.315~29.490)and vascular infiltration(β=2.578,OR=13.171,P<0.001,95%CI=3.861~44.937)were independent risk factors for axillary lymph node metastasis.Conclusion Tumor size(≥3.5 cm)and vascular invasion are independent risk factors for axillary lymph node metastasis in breast cancer.And precise treatment of breast cancer patients can be achieved according to the risk factors.