前哨淋巴结阳性2枚以下的T1～2乳腺癌患者非前哨淋巴结转移的相关因素

Risk Factors of Non-Sentinel Lymph Node Metastasis in T1～2 Invasive Breast Cancer Patients with 1 ～2 Positive Sentinel Lymph Nodes

[目的]分析前哨淋巴结2枚以下阳性的T1～2乳腺癌患者的非前哨淋巴结转移状态及预测因素。[方法]回顾性分析2016年1月至2017年12月我院收治的行前哨淋巴结活检并证实为1～2枚阳性,进一步行腋窝淋巴结清扫术患者230例的临床资料,采用单因素和多因素分析非前哨淋巴结转移的影响因素。[结果]本研究共纳入1～2枚前哨淋巴结阳性早期乳腺癌病例230例,64例(27.8%)患者非前哨淋巴结转移。单因素分析显示,非前哨淋巴结转移与肿瘤大小、肿瘤位置、脉管瘤栓、结外侵犯、前哨淋巴结转移类型、阴性前哨淋巴结数目、前哨淋巴结转移比例相关(P<0.05)。Logistic回归分析结果显示肿瘤大小、肿瘤位置和前哨淋巴结转移比例是非前哨淋巴结转移的独立预测因素(P<0.05)。纳入此3项独立预测因素建模绘制ROC曲线,AUC值为0.759。[结论]肿瘤大小、肿瘤位置和前哨淋巴结转移比例是非前哨淋巴结转移的独立预测因素。

[Objective]To investigate the predictive factors for non-sentinel lymph nodes(NSLN)metastases in T1~2 invasive breast cancer patients with 1~2 positive sentinel lymph nodes.[Methods]From January 2016 to December 2017,230 patients with invasive breast cancer were enrolled in this prospective study.All patients underwent axillary lymph dissection(ALND),after sentinel lymph node(SLN)biopsy,1~2 positive SLNs were detected.Univariate and multivariate Logistic regression were used to analyze the risk factors for NSLN metastasis.[Results]Among 230 patients,64(27.8%)had NSLNs metastases.The univariate analysis showed that the invasive tumor size,tumor location,lymph-vascular invasion,extracapsular invasion,type of sentinel metastasis,number of negative sentinel lymph nodes,and ratio of SLN metastasis were significantly correlated with NSLN metastasis.The multivariate Logistic regression model showed that the invasive tumor size,tumor location and ratio of SLN metastasis were independent risk factors for NSLN metastasis.Taking these three independent predictors into account,the receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)value was 0.759.[Conclusions]For T1~2 breast cancer patients with 1~2 positive SLN,tumor size,tumor location and ratio of SLN metastasis are independent risk factors of NSLN metastasis.