早期乳腺癌SLN活检结果阳性的影响因素及不同分子分型预后研究

Influence factors of positive SLN biopsy results in early breast cancer and prognosis of different molecular types

目的分析早期乳腺癌前哨淋巴结(SLN)活检结果阳性的影响因素及不同分子分型的预后关系。方法回顾性选择2019年11月至2023年11月在扬州大学附属苏北人民医院进行治疗的120例早期乳腺癌患者作为研究对象,并按照SLN活检结果将其分为阳性组(n=43)和阴性组(n=77)。比较两组临床资料(年龄、月经情况、肿瘤侧别、手术类型等)和病理资料(TNM分期、分子分型、激素受体等),并对影响早期乳腺癌SLN活检结果阳性的因素进行探讨。结果两组在月经情况、肿瘤侧别以及手术类型方面比较,差异均无统计学意义(P>0.05),在年龄、TNM分期、Ki-67、Her-2、分子分型这5个因素组间比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄和Luminal A型是早期乳腺癌SLN活检结果阳性的保护因素(OR=3.077,P=0.005;OR=0.255,P=0.007),而TMN分期则是SLN活检结果阳性的危险因素(OR=2.982,P=0.005)。Her-2阳性型、三阴型患者的无病生存率明显低于Luminal A型和Luminal B型,差异有统计学意义(P<0.05)。结论早期乳腺癌SLN活检结果与其分子分型有密切关联,Luminal A型患者SLN活检结果阳性风险与其他分子分型相比较低。

Objective To analyzed the factors influencing positive biopsy results of early breast cancer with sentinel lymph node(SLN)and the prognostic relationship between different molecular types.Methods A total of 120 patients with early breast cancer who were treated in North Jiangsu People's Hospital Affiliated to Yangzhou University from November 2019 to November 2023 were taken as the research objects,and they were divided into positive group(n=43)and negative group(n=77)according to the results of SLN biopsy.The clinical data(age,menstruation,tumor side,type of surgery,etc.)and pathological data(TNM staging,molecular classification,hormone receptor,etc.)of the two groups were compared,and the factors affecting the positive SLN biopsy results of early breast cancer were discussed.Results There was no statistically significant difference between the two groups in menstruation,tumor side and type of surgery(P>0.05),there were statistically significant differences between the five factors of age,TNM stage,Ki-67,Her-2 and molecular typing(P<0.05).Multivariate Logistic regression analysis shows that age and Luminal type A were the protections for positive SLN biopsy results of early breast cancer factors(OR=3.077,P=0.005;OR=0.255,P=0.007),and TMN staging was a risk factor for a positive SLN biopsy result(OR=2.982,P=0.005).The disease-free survival rate of patients with Her-2 positive and triple negative was significantly lower than that of Luminal A and Luminal B,and the difference was statistically significant(P<0.05).Conclusion The results of SLN biopsy before early breast cancer are closely related to its molecular classification.Patients with Luminal type A have a lower risk of positive SLN biopsy results compared with other molecular classifications.