乳腺癌内乳区淋巴结转移危险因素的Meta分析

Risk factorsof internal mammary lymph node metastasis in breast cancer:A Meta-analysis

目的运用系统评价方式探讨乳腺癌内乳区淋巴结转移的危险因素,为内乳区放疗的决策提供循证依据。方法在Medline、Embase以及Cochrane library数据库中检索截至2021年1月29日发表的与内乳区淋巴结转移相关文献。采用Review Manager 5.3软件进行统计分析。结果涉及5484例乳腺癌患者的13项研究纳入Meta分析。与内乳区淋巴结转移相关的因素为:年龄≤35岁(OR=1.83,95%CI=1.33~2.51)、年龄≤40岁(OR=2.93,95%CI=1.16~7.41)、内侧或中央肿瘤(OR=1.32,95%CI=1.11~1.57)、肿瘤>2 cm(OR=1.65,95%CI=1.14~2.41)、肿瘤>5 cm(OR=1.58,95%CI=1.25~2.00)、腋窝淋巴结转移(OR=5.27,95%CI=3.72~7.47)、≥4枚阳性腋窝淋巴结(OR=6.49,95%CI=5.12~8.23)、PR阴性(OR=1.35,95%CI=1.00~1.84)。结论年轻女性、内侧或中央区肿瘤、较大肿瘤、腋窝淋巴结转移和PR阴性是乳腺癌内乳区淋巴结转移的危险因素。这些危险因素可以指导乳腺癌患者个体化治疗。

Objective The aim of this study is to explore the risk factors of internal mammary lymph node metastasis in breast cancer,which provides the evidence for the decision of radiotherapy in the internal mammary area.Methods The literatures on internal mammary lymph node metastasis published before January 29st 2021 were searched in Medline,Embase,and Cochrane library databases.Review Manager 5.3 software was used for the statistical analysis.Results A total of 13 articles were included in the Meta-analysis with 5484 patients.The risk factors of internal mammary lymph node metastasis in breast cancer were age≤35 years(OR=1.83,95%CI=1.33~2.51),age≤40 years(OR=2.93,95%CI=1.16~7.41),medial or central tumor(OR=1.32,95%CI=1.11~1.57),tumor>2 cm(OR=1.65,95%CI=1.14~2.41),tumor>5 cm(OR=1.58,95%CI=1.25~2.00),axillary lymph node metastasis(OR=5.27,95%CI=3.72~7.47),≥4 positive axillary lymph nodes(OR=6.49,95%CI=5.12~8.23),PR negative(OR=1.35,95%CI=1.00~1.84).Conclusions Young women,medial or central tumors,large tumors,axillary lymph node metastasis,and PR negative are independent risk factors of internal mammary lymph node metastasis in breast cancer.The risk factors above can be used to guide the individualized treatment of breast cancer patients.