乳腺癌患者腋窝非前哨淋巴结转移的危险因素分析

Analysis of Risk Factors for Axillary Non-Sentinel Lymph Node Metastasis in Breast Cancer Patients

目的:探讨乳腺癌患者腋窝非前哨淋巴结(NSLN)转移的危险因素。方法:收集2020年5月—2022年9月于武汉大学中南医院病理确诊为乳腺癌的患者318例,所有患者行前哨淋巴结活检均为阳性并接受腋窝淋巴结清扫术。根据术后非前哨淋巴结转移情况分组,收集患者术前腋窝超声检查、临床T分期、病理变量等指标,采用单因素和多因素Logistic分析方法研究非前哨淋巴结转移的独立危险因素。结果:318例患者中,79例(24.84%)患者存在NSLN转移,术前超声诊断特异度为97.07%,敏感度为43.04%。术前腋窝NSLN超声检查阳性(OR=3.629,95%CI:1.800,7.317)、临床T2分期(OR=3.538,95%CI:1.086,11.529)及脉管癌栓阳性(OR=2.317,95%CI:1.180,4.553)是NSLN病理阳性的独立危险因素。结论:术前NSLN超声检查阳性、临床T2分期和脉管癌栓阳性是乳腺癌患者NSLN转移的独立危险因素。

Objective:To investigate the risk factors of axillary non-sentinel lymph node(NSLN)metastasis in breast cancer patients.Methods:A total of 318 patients who were pathologically diagnosed with breast cancer in Zhongnan Hospital of Wuhan University from May 2020 to September 2022 were collected.All patients were positive in sentinel lymph node biopsy and underwent axillary lymph node dissection.The patients were grouped according to postoperative non-sentinel lymph node metastasis.The preoperative axillary ultrasound examination,clinical T staging,pathological variables and other indicators were collected.Univariate and multivariate Logistic analysis were used to evaluate the independent risk factors of non-sentinel lymph node metastasis.Results:There were 79(24.84%)had NSLN metastasis among 318 patients.The specificity and sensitivity of preoperative ultrasound diagnosis were 97.07%and 43.04%.Positive preoperative NSLN ultrasound(OR=3.629,95%CI:1.800,7.317),clinical T2 stage(OR=3.538,95%CI:1.086,11.529)and positive vascular thrombus(OR=2.317,95%CI:1.180,4.553)were independent risk factors for positive NSLN pathology.Conclusion:Positive preoperative NSLN ultrasound,clinical T2 staging and positive vascular embolus may be independent risk factors for NSLN metastasis in breast cancer patients.