前哨淋巴结阳性Luminal B型早期乳腺癌非前哨腋窝淋巴结状态对预后影响研究

Effect of non-sentinel lymph node status on prognosis of Luminal B(HER2 negative) early breast cancer with positive sentinel lymph nodes

目的研究前哨淋巴结(sentinel lymph node,SLN)阳性的Luminal B(HER2阴性)型早期乳腺癌非前哨腋窝淋巴结状态对预后的影响。方法回顾性分析2008—2014年北京大学第一医院乳腺疾病中心经治的142例临床腋窝淋巴结阴性、SLN阳性的Luminal B(HER2阴性)型早期乳腺癌病例,对其临床病理学特点及与非前哨腋窝淋巴结是否存在转移进行相关性分析,并对非前哨腋窝淋巴结转移病人和无转移病人无疾病存活率(DFS)和总存活率(OS)进行对比分析。结果 142例SLN阳性病人中,平均每例病人检出SLN(2.06±1.26)枚,Spearman双变量相关性分析显示SLN转移数目与非前哨腋窝淋巴结是否存在转移具有相关性(r=0.167,P=0.047),而二元Logistics回归分析显示年龄、体重指数、是否绝经、原发肿瘤T分期、肿瘤组织学分级、脉管癌栓与该组SLN阳性病人非前哨腋窝淋巴结是否转移无相关性。非前哨腋窝淋巴结无转移病人78例(54.9%),DFS为93%,OS为93.1%;非前哨腋窝淋巴结转移病人64例(45.1%),DFS为95.2%,OS为91.9%。经Log-rank(Mantel-Cox)检验,两组在DFS(χ~2=0.011,P=0.918)及OS(χ~2=0.348,P=0.555)上差异均无统计学意义。结论 SLN阳性的Luminal B(HER2阴性)型早期乳腺癌病人,其阳性SLN数目与非前哨腋窝淋巴结是否转移存在相关性,其他临床病理因素无相关性,而非前哨腋窝淋巴结转移组和无转移组DFS和OS差异无统计学意义。

Objective To evaluate the effect of non-sentinel lymph node status on prognosis of Luminal B(HER2 negative)early breast cancer. Methods Luminal B(HER2 negative)early breast cancer with positive sentinel lymph node treated from January 2008 to December 2014 in Peking University First Hospital entered the retrospective study.The clinicopathological features and their relationship with non-sentinel lymph nodes status were analyzed statistically.The effect of non-sentinel lymph nodes status on prognosis of Luminal B(HER2 negative)early breast cancer with positive sentinel lymph nodes were also analyzed. Results In the group of 142 patients with positive sentinel lymph nodes(SLN),the average number of SLNs detected in each patient were 2.06±1.26. The number of positive SLNs was associated with the status of non-sentinel lymph nodes,but not the age,BMI,menopause,T stage,histological grade,lympho-vascular invasion. Non-SLN axillary lymph node non-metastasis occurred in 78 patients(54.9%), DFS 93%, OS 93.1%; non-SLN axillary lymph node metastasis occurred in 64 patients(45.1%), DFS 95.2%, OS 91.9%.Based on Log-rank(Mantel-Cox) test, There was no significant difference between two groups in DFS(χ~2=0.011, P=0.918) and OS(χ~2=0.348, P=0.555).Conclusion The number of positive sentinel lymph nodes in Luminal B(HER2 negative)early breast cancer patients with sentinel lymph nodes metastasis were associated with the status of non-sentinel lymph nodes.There were no statistical differences between non-sentinel lymph nodes metastasis group and non-metastasis group in disease free survival and over-roll survival.