乳腺癌患者临床病理及超声特征与同侧腋窝淋巴结转移的关系

Correlation between clinicopathological and ultrasound characteristics and ipsilateral axillary lymph node metastasis in breast cancer patients

目的探讨乳腺癌患者临床病理及超声特征与同侧腋窝淋巴结转移的关系。方法选取2019年1月至7月在本院就诊的乳腺癌患者120例作为研究对象。所有患者均接受手术治疗,术中行同侧腋窝淋巴结清扫术或前哨淋巴结活检。记录患者临床病理资料和原发灶超声特征等相关参数,对相关参数进行单因素分析及多因素Logistic回归分析。结果同侧腋窝淋巴结转移阳性49例,阴性71例。同侧腋窝淋巴结转移阳性和阴性患者在年龄、雌激素受体(estrogen receptor,ER)水平、孕激素受体(progesterone receptor,PR)水平、人表皮生长因子受体2(human epidermal growth factor receptor-2,HER2)水平、Ki-67表达及分子分型方面比较,差异均无统计学意义(均P>0.05)。Logistic回归分析显示,结节大小及所在象限是同侧腋窝淋巴结转移与否的独立危险因素(均P<0.05)。不同结节形态和血流分级患者同侧腋窝转移淋巴结数目比较,差异均具有统计学意义(均P<0.05)。结论乳腺癌患者超声特征可作为同侧腋窝淋巴转移诊断的重要辅助手段,特别是结节大小和所在象限是乳腺癌同侧腋窝淋巴结转移的重要预测因子,结节血流状态对乳腺癌同侧腋窝淋巴结转移数量有非常重要的预测作用。

Objective To investigate the correlation between the clinicopathological and ultrasound characteristics and ipsilateral axillary lymph node metastasis in breast cancer patients.Methods A total of 120 breast cancer patients who were treated in our hospital from January to July 2019 were selected.All patients underwent surgical treatment,and had ipsilateral axillary lymph node dissection or sentinel lymph node biopsy during the operation.The clinicopathological data,the ultrasound characteristics of the primary tumor and other relevant parameters were recorded,and univariate and multivariate logistic regression analysis was used to evaluate the relevant parameters.Results There were 49 cases with positive ipsilateral axillary lymph node metastasis and 71 cases with negative ipsilateral axillary lymph node metastasis.There were no significant differences in age,estrogen receptor(ER)level,progesterone receptor(PR)level,human epidermal growth factor receptor-2(HER2)level,Ki-67 expression and molecular subtypes between patients with positive and negative ipsilateral axillary lymph node metastasis(all P>0.05).Logistic regression analysis showed that nodule size and quadrant were independent risk factors for ipsilateral axillary lymph node metastasis(both P<0.05).There was a statistically significant difference in the number of ipsilateral axillary metastatic lymph nodes among patients with different nodule morphology and blood flow grades(both P<0.05).Conclusions Ultrasound characteristics of breast cancer patients can be used as an important auxiliary means for the diagnosis of ipsilateral axillary lymph node metastasis.In particularly,the size and location of nodules are important predictors of ipsilateral axillary lymph node metastasis of breast cancer,and the state of nodule blood flow plays a very important role in predicting ipsilateral axillary lymph node metastasis of breast cancer.