三阴性乳腺癌患者腋窝淋巴结转移与血清低密度脂蛋白胆固醇水平的关系

Correlation between axillary lymph node metastases and serum low-density lipoprotein cholesterol levels in patients with triple-negative breast cancer

目的探讨三阴性乳腺癌(TNBC)腋窝淋巴结转移与低密度脂蛋白胆固醇(LDL-C)的相关性。方法回顾性选取2010年1月至2016年12月于山东第一医科大学附属省立医院就诊并术后病理确诊的TNBC患者107例(TNBC组)、人表皮生长因子受体2过表达型乳腺癌患者122例(HER-2组)、乳腺良性肿瘤患者136例(良性肿瘤组),另选取同期的健康体检者155例(对照组),均为女性。根据腋窝淋巴结位置,将淋巴结分为Ⅰ、Ⅱ、Ⅲ组。记录受试者年龄、体重指数、绝经状况、血清LDL-C水平以及TNBC患者的临床病理因素,分析腋窝淋巴结转移的危险因素。结果良性肿瘤组、HER-2组、TNBC组体重指数均高于对照组,HER-2组、TNBC组绝经比例、LDL-C水平均高于对照组和良性肿瘤组,且TNBC组LDL-C水平高于HER-2组(均P<0.05)。单因素分析结果显示,LDL-C与TNBC患者年龄、绝经、淋巴结转移相关(均P<0.05);Ⅰ组腋窝淋巴结转移与TNM分期、LDL-C相关,Ⅱ、Ⅲ组转移与TNM分期相关(均P<0.05)。二元Logistic回归分析结果显示,LDL-C(比值比=3.075,95%置信区间:1.133~8.343)和TNM分期(比值比=58.843,95%置信区间:7.396~468.124)是TNBC患者Ⅰ组腋窝淋巴结转移的独立危险因素(均P<0.05)。结论高水平LDL-C会促进TNBC腋窝淋巴结转移,是Ⅰ组淋巴结转移的独立危险因素。

Objective To analyze the correlation between axillary lymph node metastasis and low-density lipoprotein cholesterol(LDL-C)in triple-negative breast cancer(TNBC).Methods From January 2010 to December 2016,107 patients with TNBC(TNBC group),122 patients with human epidermal growth factor receptor 2 overexpressing breast cancer(HER-2 group)and 136 patients with benign breast tumors(benign tumor group)admitted to Shandong Provincial Hospital Affiliated to Shandong First Medical University and diagnosed by postoperative pathological examination,and another 155 healthy examiners(control group)in the same period were selected retrospectively.All of them were females.According to the position of axillary lymph nodes,they were divided into groupⅠ,ⅡandⅢ.The age,body mass index,menopausal status,LDL-C levels,as well as clinical and pathological factors of TNBC patients were recorded to analyze the risk factors for axillary lymph node metastasis.Results The body mass indexes in the benign tumor group,HER-2 group and TNBC group were higher than that in the control group,the menopausal rates and LDL-C levels in the HER-2 group and TNBC group were higher than those in the control group and benign tumor group,and the LDL-C level in the TNBC group was higher than that in the HER-2 group(all P<0.05).Univariate analysis showed that LDL-C was correlated with age,menopause and lymph node metastasis in TNBC patients(all P<0.05),axillary lymph node metastasis in groupⅠwas correlated with TNM stage and LDL-C,and metastases in groupⅡandⅢwere correlated with TNM stage(all P<0.05).Binary logistic regression analysis results showed that LDL-C(odds ratio=3.075,95%confidence interval:1.133-8.343)and TNM stage(odds ratio=58.843,95%confidence interval:7.396-468.124)were independent risk factors for axillary lymph node metastasis of patients with TNBC in groupⅠ(both P<0.05).Conclusion High level of LDL-C can promote axillary lymph node metastasis,and it is an independent risk factor for lymph node metastasis in groupⅠ.