前哨淋巴结阳性乳腺癌患者腋窝非前哨淋巴结转移的相关危险因素研究

Risk factors for axillary non-sentinel lymph node metastasis in patients with sentinel lymph node-positive breast cancer

目的:研究前哨淋巴结(SLN)阳性乳腺癌患者腋窝非SLN转移者的相关危险因素,为临床诊断、治疗提供相关参考依据。方法:选取2015年1月到2018年12月我院收治的SLN阳性乳腺癌患者200例,其中腋窝非SLN转移者96例,腋窝非SLN无转移者104例,分析SLN阳性乳腺癌患者腋窝非SLN转移的相关危险因素。结果:年龄、雌激素受体、组织分化、病理类型、脉管浸润情况与SLN阳性乳腺癌患者腋窝非SLN转移无明显相关性(P>0.05);肿瘤大小、是否多发肿瘤、阳性SLN数目、阴性SLN数目、SLN转移率是SLN阳性乳腺癌患者腋窝非SLN转移的影响因素(P<0.05);经多因素Logistic回归分析可知,肿瘤>2.0 cm、多发肿瘤、阳性SLN数目、SLN转移率是SLN阳性乳腺癌患者腋窝非SLN转移的独立危险因素(P<0.05)。结论:肿瘤>2.0 cm、多发肿瘤、阳性SLN数目、SLN转移率是SLN阳性乳腺癌患者腋窝非SLN转移的独立危险因素,临床应及早明确上述情况,为判断腋窝非SLN转移、制定治疗方案提供可靠信息支持。

Objective:To determine the risk factors for axillary non-sentinel lymph node(SLN)metastasis in patients with SLN-positive breast cancer,and to provide relevant reference for clinical diagnosis and treatment.Methods:A total of 200 patients with SLN-positive breast cancer admitted to our hospital between January 2015 and December 2018 were included in the study,including 96 of axillary non-SLN metastasis and 104 of axillary non-SLN non-metastasis.The risk factors for axillary non-SLN metastasis in patients with SLN-positive breast cancer were determined.Results:There were no significant correlation between age,estrogen receptor,tissue differentiation,pathological type,vascular invasion and axillary non-SLN metastasis in patients with SLN-positive breast cancer(P>0.05).Tumor size,multiple tumors,positive SLN number,negative SLN number and SLN metastasis rate were the influencing factors of axillary non-SLN metastasis in patients with SLN-positive breast cancer(P<0.05).Multivariate logistic regression analysis showed that tumors>2.0 cm,multiple tumors,positive SLN number,and SLN metastasis rate were the independent risk factors for axillary non-SLN metastasis in patients with SLN-positive breast cancer(P<0.05).Conclusion:Tumors>2.0 cm,multiple tumors,positive SLN number,and SLN metastasis rate are independent risk factors for axillary non-SLN metastasis in patients with SLN-positive breast cancer.The clinical condition should be clearly identified,and reliable information support should be provided for judging the axillary non-SLN metastasis and formulating treatment protocols.