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Application of sentinel lymph node (SLN) biopsy in breast cancer patients 被引量:1
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作者 Tao Zhang Baoning Zhang +6 位作者 Hong Wang Baoping Chen Xiliang Wei Ying Fu Lin Liu HongyingYang Shengzu Ghen 《The Chinese-German Journal of Clinical Oncology》 CAS 2007年第1期52-54,共3页
Objective: To discuss if the sentinel lymph node (SLN) biopsy is able to reflect the status of the axillary lymph node and the application of this technic in clinic. Methods: Using^ 99mTc-signed dextran, SLN-biop... Objective: To discuss if the sentinel lymph node (SLN) biopsy is able to reflect the status of the axillary lymph node and the application of this technic in clinic. Methods: Using^ 99mTc-signed dextran, SLN-biopsy (SLNB) was carried out in 182 cases with breast cancer during May 1999 to September 2006. During the operation, y-detector was used for orientation. After the SLNB, a modified radical mastectomy or breast conserving surgery were carried out to the patients, then a particular separate pathological examination of the SLN was made. Results: 178 cases of SLNB were carried out successfully, and the success rate was 97.8%, the out-checked SLN of each case ranged from 1 to 4, with an average of 2.5. All SLN was located at the first level of axilla, sensitivity of the SLN B was 93.4%, specificity was 100%, false negative rate was 6.6%, false positive rate was 0, accuracy was 97.8%, positive predictive value was 100.0%, negative predictive value was 96.7%, and Youden's index was 0.934. Immunohistochemical examination was carried out in 59 cases of SLN, and 14 cases showed the existences of micro-metastasis, however, metastasis had not been found in non-SLN of these cases. Conclusion: SLN is able to reflect the metastasis of the axillary lymph node, and this can suggest the necessity of the axillary dissection in clinic. The SLNB using the isotope-tracer technic is simple and accurate. 展开更多
关键词 breast neoplasms / surgery radionuclide imaging sentinel lymph node
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Relationship between Lymphatic Vessel Density and Lymph Node Metastasis of Invasive Micropapillary Carcinoma of the Breast 被引量:1
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作者 Xiaojing Guo Ling Chen Ronggang Lang Yu Fan Li Fu 《Chinese Journal of Clinical Oncology》 CSCD 2006年第1期15-19,共5页
OBJECTIVE To investigate the relationship between lymphatic vessel density and lymph node metastasis of invasive micropapillary carcinoma (IMPC) of the breast. METHODS The immunohistochemical study for vascular endoth... OBJECTIVE To investigate the relationship between lymphatic vessel density and lymph node metastasis of invasive micropapillary carcinoma (IMPC) of the breast. METHODS The immunohistochemical study for vascular endothelial growth factor-c (VEGF-C), VEGF Receptor-3 (VEGFR-3) and lymphatic vessel density of 51 cases of IMPC were performed, and lymph node metastases were examined by microscopic analysis of these cases. RESULTS In IMPC, VEGF-C was expressed in the cytoplasm and/or on the membrane of the tumor cells, and the expression of VEGF-C showed a positive correlation with lymph node metastasis (P<0.01). Lymphatic vessel density was determined by the number of micro-lymphatic vessels with VEGFR-3 positive staining. Lymphatic vessel density was positively correlated with VEGF-C expression (P<0.01) and lymph node metastasis (P<0.01). The percentage of IMPC in the tumor was not associated with the incidence of lymph node metastasis. The metastatic foci in lymph nodes were either pure or predominant micropapillary carcinoma. CONCLUSION The results suggested that VEGF-C overexpression stimulated tumor lymphangiogenesis, and the increased lymphatic vessel density may be the key factor that influenced lymph node metastasis of IMPC. 展开更多
关键词 breast neoplasm invasive micropapillary carcinoma (IMPC) vascular endothelial growth factor (VEGF) lymph node metastasis.
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Determination of Metastatic Axillary Lymph Node in Breast Cancer: Differentiation with Dynamic MRI Examination by Signal Intensity-Time Curves
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作者 Duzgun Yildirim Baki Ekci +1 位作者 Bengi Gurses Ahmet Kaur 《Journal of Cancer Therapy》 2011年第4期557-566,共10页
Purpose: We aimed to evaluate the role of dynamic magnetic resonance imaging (MRI) in the detection of axillary lymph node metastasis based on the signal intensity-time curves. Materials and Methods: The data of 120 p... Purpose: We aimed to evaluate the role of dynamic magnetic resonance imaging (MRI) in the detection of axillary lymph node metastasis based on the signal intensity-time curves. Materials and Methods: The data of 120 patients (benign patients, n = 91;malignant patients, n = 29) who underwent dynamic breast MRI were reviewed. The lymph nodes with the strongest criteria for malignancy (morphological-dynamic properties) were included in the analysis. Signal intensity-time curves were plotted by the software. Results: Of 29 patients with breast cancer, axillary lymph nodes were involved in 21 and not involved in the remaining 8. There was no significant difference between benign and malignant cases in terms of the distributions of Type Ia, Type Ib and Type IV curves (p = 0.12), whereas a significant difference was found between benign and malignant cases in terms of the distributions of Type II and III curves (p Conclusion: On dynamic MRI studies, benign and metastatic lymph nodes display different signal intensity-time curves. 展开更多
关键词 Dynamic Magnetic Resonance Imaging breast neoplasms AXILLARY lymph nodes lymphATIC Metastasis Sensitivity-Specificity
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Axillary Sentinel Lymph Node Biopsy for Breast Cancer and Melanoma Patients after Previous Axillary Surgery: A Systematic Review
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作者 Maurice Matter Sebastien Romy +2 位作者 Ariane Boubaker Olivier Michielin Nicolas Demartines 《Journal of Cancer Therapy》 2013年第9期1395-1402,共8页
Objective: Sentinel lymph node biopsy (SLNB) is a validated staging technique for breast carcinoma. Some women are exposed to have a second SLNB due to breast cancer recurrence or a second neoplasia (breast or other).... Objective: Sentinel lymph node biopsy (SLNB) is a validated staging technique for breast carcinoma. Some women are exposed to have a second SLNB due to breast cancer recurrence or a second neoplasia (breast or other). Due to modified anatomy, it has been claimed that previous axillary surgery represents a contra-indication to SLNB. Our objective was to analyse the literature to assess if a second SLNB is to be recommended or not. Methods: For the present study, we performed a review of all published data during the last 10 years on patients with previous axilla surgery and second SLNB. Results: Our analysis shows that second SLNB is feasible in 70%. Extra-axillary SNs rate (31%) was higher after radical lymph node dissection (ALND) (60% - 84%) than after SLNB alone (14% - 65%). Follow-up and complementary ALND following negative and positive second SLNB shows that it is a reliable procedure. Conclusion: The review of literature confirms that SLNB is feasible after previous axillary dissection. Triple technique for SN mapping is the best examination to highlight modified lymphatic anatomy and shows definitively where SLNB must be performed. Surgery may be more demanding as patients may have more frequently extra-axillary SN only, like internal mammary nodes. ALND can be avoided when second SLNB harvests negative SNs. These conclusions should however be taken with caution because of the heterogeneity of publications regarding SLNB and surgical technique. 展开更多
关键词 breast neoplasms MELANOMA Sentinel lymph Node Biopsy Dissection lymphATIC Vessels SURGERY lymphATIC Anatomy
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Sarcoidosis imitating breast cancer metastasis:a case report and literature review 被引量:1
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作者 Teimuraz Kochoyan Mobil Akhmedov +1 位作者 Alexander Shabanov Ilya Terekhov 《Cancer Biology & Medicine》 SCIE CAS CSCD 2016年第3期396-398,共3页
Sarcoidosis is a benign systematic granulomatous disorder of unknown etiology and is associated with various malignancies.However, granulomatous and metastatic lymph node lesions are difficult to distinguish even when... Sarcoidosis is a benign systematic granulomatous disorder of unknown etiology and is associated with various malignancies.However, granulomatous and metastatic lymph node lesions are difficult to distinguish even when using precise and modern diagnostic methods, such as positron emission tomography. Thus, histological verification is the only method that can be used to accurately describe the nature of this disease. In this article, we report a case of non-luminal HER-2/neu-positive breast cancer in a patient without history of sarcoidosis and suspected to have metastatic disease. 展开更多
关键词 SARCOIDOSIS breast neoplasms METASTASIS GRANULOMATOUS lymph node
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Prognostic and Predictive Factors of Early Breast Cancer
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作者 Zhong-jie CHEN Mei-ying YAN +4 位作者 Hong-qing ZHUANG Jian-lei HAO Rui-ying LI Zhi-yong YUAN Ping WANG 《Clinical oncology and cancer researeh》 CAS CSCD 2010年第4期246-252,共7页
OBJECTIVE To identify risk factors for relapse and death in patients with T1 to T2 breast cancer with 0-3 positive axillary lymph nodes.METHODS The case files of 540 breast cancer patients with T1-T2 tumors with 0-3 p... OBJECTIVE To identify risk factors for relapse and death in patients with T1 to T2 breast cancer with 0-3 positive axillary lymph nodes.METHODS The case files of 540 breast cancer patients with T1-T2 tumors with 0-3 positive nodes were reviewed retrospectively. Ten-year locoregional recurrence (LRR), distant recurrence (DR), disease-free survival (DFS) and overall survival (OS) of the patients were analyzed. Univariate statistical analysis and Cox proportional hazards models were carried out with SPSS so ware v.16.0.RESULTS The median follow-up of all the patients was 7.2 years. On multivariate analysis, 〉 20% positive axillary nodes was the only variable that influenced LRR adversely (hazard ratio[HR], 12.816; 95% confidence interval, 4.657-35.266, P 〈 0.001); 〉 20% positive axillary nodes and ductal carcinoma were variables that influenced DR adversely (HR, 11.088, 95% confidence interval, 3.807-32.297, P 〈 0.001; HR, 0.390, 95% confidence interval, 0.179-0.851, P = 0.018); 1-3 positive axillary nodes and 〉 20% positive axillary nodes were the only variables that had negative e. ect on 10-year OS (HR, 2.110, 95% confi dence interval, 1.364-3.264, P = 0.001; HR, 10.244, 95% confidence interval, 3.497-30.011, P 〈 0.001) and they were also adverse prognostic variables on 10-year DFS (HR, 1.634, 95% confidence interval, 1.171-2.279, P = 0.004; HR, 7.339, 95% confi dence interval,2.906-18.530, P 〈 0.001).CONCLUSION Axillary lymph nodal status is the only risk factor with a signifi cant impact on 10-year LRR, DR, OS and DFS.Patients with T1-T2 breast cancer with 0-3 positive lymph nodes have the LRR and DR of over 10 years, and the OS and DFS of less than 10 years, compared to patients with negative lymph nodes.Histology in primary tumors is a signifi cant prognostic factor for the 10-year DR. 展开更多
关键词 breast neoplasms RECURRENCE DEATH PROGNOSIS lymph nodes
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Non-Axillary Sentinel Node in Breast Cancer.Are we Staging Correctly?A Multicenter Study
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作者 Javier Encinas Méndez Joan Francesc Julián Ibánez +4 位作者 Manel Cremades Pérez Jordi Navinés Josep Verge Schulte-Eversum Manel Fraile López-Amor Manel Armengol Carrasco 《Advances in Breast Cancer Research》 2014年第4期124-130,共7页
Purpose: The study of the sentinel lymph node is the best technique to stage, have a prognosis and decide the adequate treatment in breast cancer. The usual technique implies studding the axillary lymph node. Our work... Purpose: The study of the sentinel lymph node is the best technique to stage, have a prognosis and decide the adequate treatment in breast cancer. The usual technique implies studding the axillary lymph node. Our work tries to identify affected nodes in other regions apart from the axilla and its possible impact in staging and treatment. Methods: The sentinel lymph node technique was performed on 1660 patients included in an observational and multicentric study designed to observe the presence of metastatic cells in axillary and non-axillary lymph nodes. Results: In 19% of the patients the sentinel lymph node was detected in non-axillary regions. In these cases metastatic cells were more frequent which could suppose a change in the stage and/or treatment. As protective factor against non-axillary nodes involvement we found the localization of the cancer in external quadrants while youth and injecting the tracer inside the tumor were found to be risk factors. Conclusions: Detecting and studding non-axillary lymph nodes in breast cancer leads to a more precise staging of the disease which could imply a change in the optimal treatment. 展开更多
关键词 breast neoplasms Sentinel lymph Node Biopsy Neoplasm Staging
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乳腺癌前哨淋巴结MRI研究进展 被引量:2
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作者 罗实 张莹莹 于韬 《国际医学放射学杂志》 2024年第1期66-69,共4页
无创性方法准确评估乳腺癌前哨淋巴结状态对于避免不必要的外科手术及选择最佳治疗方案具有重要意义。扩散加权成像(DWI)和动态增强MRI(DCE-MRI)等多种MRI技术可为术前评估乳腺癌前哨淋巴结状态提供有价值的信息。就MRI评估乳腺癌前哨... 无创性方法准确评估乳腺癌前哨淋巴结状态对于避免不必要的外科手术及选择最佳治疗方案具有重要意义。扩散加权成像(DWI)和动态增强MRI(DCE-MRI)等多种MRI技术可为术前评估乳腺癌前哨淋巴结状态提供有价值的信息。就MRI评估乳腺癌前哨淋巴结状态的研究进展进行综述。 展开更多
关键词 乳腺肿瘤 前哨淋巴结 磁共振成像
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全乳切除术后放射治疗对前哨淋巴结微转移早期乳腺癌患者预后影响的Meta分析
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作者 格桑卓嘎 韩丽飞 +2 位作者 王宝偲 张亚男 胡浩霖 《东南大学学报(医学版)》 CAS 2024年第1期97-104,共8页
目的:荟萃文献,对比分析前哨淋巴结微转移早期乳腺癌患者全乳切除术后行与未行放射治疗的预后。方法:检索中国生物医学文献数据库(China Biology Medicine,CBM)、中国期刊全文数据库(China National Knowledge Infrastructure,CNKI)、维... 目的:荟萃文献,对比分析前哨淋巴结微转移早期乳腺癌患者全乳切除术后行与未行放射治疗的预后。方法:检索中国生物医学文献数据库(China Biology Medicine,CBM)、中国期刊全文数据库(China National Knowledge Infrastructure,CNKI)、维普(VIP)、万方数据库、PubMed数据库、Embase数据库、Web of science(WOS)数据库、Cochrane数据库,由2名研究者各自独立对入选研究的有关试验设计、研究对象特征、研究结果等进行摘录,采用纽卡斯尔渥太华量表进行质量评价,采用Stata 17.0及Review Manager 5.4进行Meta分析。结果:最终筛选出9篇相关文献,均为回顾性研究。中位随访30~98个月。术后放射治疗组与非放射治疗组乳腺癌特异性生存期(breast cancer-specific survival,BCSS)差异无统计学意义(HR=1.18,95%CI:0.94~1.48,Z=1.43,P=0.15);两组无病生存期(disease-free survival,DFS)差异亦无统计学意义(HR=0.51,95%CI:0.07~3.62,Z=-0.668,P=0.50);两组总生存期(overall survival,OS)差异亦无统计学意义(HR=1.02,95%CI:0.93~1.12,Z=0.39,P=0.70)。结论:前哨淋巴结微转移早期乳腺癌患者(T0、T1~2NmiM0)全乳切除术后予以放射治疗并不能改善患者的BCSS、DFS、OS。 展开更多
关键词 乳腺肿瘤 前哨淋巴结微转移 全乳切除术 放射治疗 META分析
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基于DCE-MRI瘤内及瘤周影像组学的列线图预测早期乳腺癌腋窝淋巴结负荷的价值
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作者 郑彭玮 林桂涵 +3 位作者 陈炜越 应海峰 李程超 纪建松 《放射学实践》 CSCD 北大核心 2024年第10期1333-1339,共7页
目的:探讨基于动态增强MRI(DCE-MRI)瘤内及瘤周影像组学的列线图在预测早期(cT1-2N0-1M0期)乳腺癌患者ALN负荷中的应用价值。方法:回顾性分析2016年3月-2022年12月经手术病理证实且临床分期为cT1-2N0-1M0期的463例乳腺癌患者的临床病理... 目的:探讨基于动态增强MRI(DCE-MRI)瘤内及瘤周影像组学的列线图在预测早期(cT1-2N0-1M0期)乳腺癌患者ALN负荷中的应用价值。方法:回顾性分析2016年3月-2022年12月经手术病理证实且临床分期为cT1-2N0-1M0期的463例乳腺癌患者的临床病理和MRI影像资料。采用完全随机法以7:3的比例将患者分为训练集(n=324)和验证集(n=139)。使用Radcloud平台提取DCE-MRI图像肿瘤内部和周围3 mm、5 mm和7 mm区域的影像组学特征,通过降维保留纳入模型的最优特征。采用支持向量机分别构建相应的影像组学模型。将单因素分析中P<0.05的临床特征纳入多因素logistic回归分析,得到与ALN负荷相关的独立危险因素,并以此建立临床模型。最后,基于临床危险因素和瘤内+最佳瘤周影像组学评分(Rad-score)建立列线图模型。采用受试者工作特征(ROC)曲线对模型的预测性能进行评价,并计算出曲线下面积(AUC)、敏感度、特异度和准确度。结果:瘤内模型在训练集和验证集中的AUC分别为0.809、0.762。瘤周特征建模以瘤周5 mm范围结果最佳,在训练集和验证集中的AUC分别为0.745、0.727。多因素logistic回归分析显示肿瘤最大径和MR报告淋巴结状态是预测早期乳腺癌患者ALN高负荷的独立危险因素。进一步结合临床危险因素和Rad-score(瘤内+瘤周5 mm)建立列线图。ROC结果显示该列线图表现出良好的预测性能,在训练集中的AUC、敏感度、特异度和准确度分别为0.875、0.736、0.863、0.825;在验证集中的AUC、敏感度、特异度和准确度分别为0.830、0.692、0.850、0.800。结论:基于DCE-MRI瘤内及瘤周影像组学的列线图能够较好地预测早期乳腺癌患者的ALN负荷。 展开更多
关键词 乳腺肿瘤 腋窝 淋巴结 磁共振成像
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医保DIP支付背景下乳腺癌腋窝淋巴结转移的预测因素探讨
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作者 谢皓冉 李一浩 +4 位作者 刘成 夏瑜婷 裘圣蕾 熊斌 冯其贞 《天津医药》 CAS 2024年第11期1193-1197,共5页
目的探究乳腺癌腋窝淋巴结转移的预测因素,为医保按病种分值付费(DIP)支付模式下的临床决策提供依据。方法715例乳腺癌患者据术后淋巴结转移情况分为转移组309例和非转移组406例,分析2组年龄>60岁、是否绝经、体质量指数(BMI)>24 ... 目的探究乳腺癌腋窝淋巴结转移的预测因素,为医保按病种分值付费(DIP)支付模式下的临床决策提供依据。方法715例乳腺癌患者据术后淋巴结转移情况分为转移组309例和非转移组406例,分析2组年龄>60岁、是否绝经、体质量指数(BMI)>24 kg/m2、高血糖(GLU>6.1 mmol/L)、高甘油三酯(TG>1.7 mmol/L)、肿瘤最大直径、肿瘤距乳头距离、肿瘤所在象限等情况;同时分析2组间乳腺癌组织学分级以及免疫组织化学检测组织标本中雌激素受体(ER)、孕激素受体(PR)、细胞核增殖抗原(Ki-67)及人表皮生长因子受体-2(Her-2)的表达情况。以病理诊断为金标准,考察胸部CT和乳腺彩超检查的一致性、敏感度和特异度。结果与非转移组比较,转移组中肿瘤最大直径>2 cm、组织学分级Ⅲ级、Ki-67高表达、ER高表达者比例增加,肿瘤位于外上象限、肿瘤距乳头距离>3 cm、高TG者比例减少(P<0.05);胸部CT检查与病理诊断的一致性优于乳腺彩超(Kappa值分别为0.493和0.353,P<0.05);Logistic回归分析显示,组织学分级Ⅲ级、ER高表达、肿瘤最大直径>2 cm、胸部CT确诊是腋窝淋巴结转移的危险因素(P<0.05)。结论医保DIP支付模式下结合乳腺癌腋窝淋巴结转移的预测因素可为临床决策提供一定参考。 展开更多
关键词 乳腺肿瘤 淋巴结 肿瘤转移 Logistic模型 胸部CT 按病种分值付费
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PD-L1、CD163和CD8在淋巴细胞为主型乳腺原发癌及淋巴结转移癌中的表达及意义
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作者 陈妙玲 杨月 +1 位作者 张会芳 韩玉贞 《临床与实验病理学杂志》 CAS 北大核心 2024年第5期520-525,530,共7页
目的探讨淋巴细胞为主型乳腺癌(lymphocyte-predominant breast cancer,LPBC)中程序性死亡配体-1(programmed death-ligand 1,PD-L1)、CD163和CD8的表达和预后价值,并比较原发癌和相应淋巴结转移癌中PD-L1、CD163和CD8的表达。方法收集... 目的探讨淋巴细胞为主型乳腺癌(lymphocyte-predominant breast cancer,LPBC)中程序性死亡配体-1(programmed death-ligand 1,PD-L1)、CD163和CD8的表达和预后价值,并比较原发癌和相应淋巴结转移癌中PD-L1、CD163和CD8的表达。方法收集具有完整病理资料的LPBC 82例,采用免疫组化EnVision法检测82例原发癌及23例相应淋巴结转移癌中PD-L1、CD163和CD8的表达,并分析其与临床病理特征及预后的相关性,以及原发癌和转移癌的表达差异。结果原发癌中PD-L1在肿瘤细胞(tumor cell,TC)和免疫细胞(immune cell,IC)的阳性率分别为25.61%(21/82)、79.27%(65/82),其中TC-PD-L1在组织学分级Ⅱ和Ⅲ级的阳性率分别为18.00%(9/50)、37.50%(12/32),TC-PD-L1的表达与组织学分级有关(P<0.05);IC-PD-L1在肿瘤最大径≤2 cm和>2 cm的阳性率分别为66.67%(18/27)、85.45%(47/55),在Ki67≤20%和>20%的阳性率分别为60.00%(12/20)、85.48%(53/62),IC-PD-L1的表达与肿瘤最大径、Ki67有关(P均<0.05);TC-PD-L1的表达与CD8+瘤内肿瘤浸润淋巴细胞(intratumoral tumor-infiltrating lymphocytes,iTILs)密度呈正相关(r=0.277,P<0.05),IC-PD-L1的表达与CD163呈正相关(r=0.259,P<0.05);CD163高表达与较短的无瘤生存期(disease free survival,DFS)显著相关(P<0.05)。原发癌和淋巴结转移癌的TC-PD-L1和IC-PD-L1表达一致率分别为82.61%(19/23)、47.82%(11/23),差异无统计学意义(P均>0.05);CD163和CD8+iTILs均存在显著差异(P均<0.05)。结论原发癌中PD-L1的表达与不良预后的临床病理特征相关,CD163高表达提示预后差。LPBC原发癌和相应淋巴结转移癌的肿瘤免疫微环境存在差异,对转移癌PD-L1的重新评估或有助于指导临床进行肿瘤免疫治疗。 展开更多
关键词 乳腺肿瘤 淋巴细胞为主型乳腺癌 淋巴结转移 PD-L1 CD163
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MRI术前预测乳腺癌前哨淋巴结转移的价值
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作者 施益洁 陈青青 +1 位作者 何杰 胡红杰 《中国医学影像学杂志》 CSCD 北大核心 2024年第10期1021-1026,共6页
目的探讨MRI多模态参数对乳腺癌前哨淋巴结(SLN)转移的预测价值,并制订有效预测模型,以降低SLN的不必要活检率。资料与方法回顾性分析2019年1月—2021年12月浙江大学医学院附属邵逸夫医院经手术病理证实的310例c N0乳腺癌的术前MRI影像... 目的探讨MRI多模态参数对乳腺癌前哨淋巴结(SLN)转移的预测价值,并制订有效预测模型,以降低SLN的不必要活检率。资料与方法回顾性分析2019年1月—2021年12月浙江大学医学院附属邵逸夫医院经手术病理证实的310例c N0乳腺癌的术前MRI影像资料,根据SLN有无转移分为阳性组及阴性组。由2名放射科医师独立评估乳腺病变的影像特征,比较两组参数差异,并筛选独立预测因子构建模型、评估诊断效能。结果SLN阳性组乳腺病变位于外上象限(χ^(2)=14.94)、非单发(χ^(2)=9.29)、环形强化(χ^(2)=9.23)及邻近血管增多征象阳性比例(χ^(2)=9.91)均高于阴性组,阳性组病变更大(Z=-2.97、-2.73)、早期强化率更高(t=-3.48)、最小表观扩散系数及相对表观扩散系数(病变最小表观扩散系数/腺体表观扩散系数)更低(Z=-7.33、-10.74),(P均<0.05)。Logistic回归结果显示,病变部位(OR=4.17,95%CI 1.86~9.35,P=0.001)、早期强化率(OR=1.01,95%CI 1.00~1.02,P=0.019)及相对表观扩散系数(OR=54.67,95%CI 23.72~126.02,P<0.001)是SLN转移的独立危险因子。联合病变部位和相对表观扩散系数的模型预测性能最佳,其阴性预测值为96.5%,可降低46.1%的不必要活检率。结论基于常规MRI特征参数的SLN术前预测模型(病变部位、相对表观扩散系数)具有可靠的阴性预测价值,有望降低近半数c N0期乳腺癌的不必要活检率。 展开更多
关键词 乳腺肿瘤 前哨淋巴结 磁共振成像 病理学 外科 诊断 鉴别 预测
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乳腺癌中PRSS22表达与淋巴结转移及预后的关系
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作者 高兆欣 王亚文 陈旭 《中国现代普通外科进展》 CAS 2024年第2期111-116,共6页
目的:探究PRSS22在乳腺癌组织中的表达情况及其与临床病理因素、患者预后的关系。方法:收集山东大学齐鲁医院56例新鲜乳腺癌组织及10例癌旁乳腺组织,使用实时定量PCR检测PRSS22 mRNA的表达情况,分析其与患者临床病理因素的关系。使用生... 目的:探究PRSS22在乳腺癌组织中的表达情况及其与临床病理因素、患者预后的关系。方法:收集山东大学齐鲁医院56例新鲜乳腺癌组织及10例癌旁乳腺组织,使用实时定量PCR检测PRSS22 mRNA的表达情况,分析其与患者临床病理因素的关系。使用生物信息学网站分析乳腺癌PRSS22的表达情况及预后价值。使用迁移浸润实验探讨PRSS22对乳腺癌细胞迁移浸润能力的影响。结果:PRSS22在乳腺癌组织较癌旁乳腺组织表达上调,PRSS22在存在淋巴结转移的乳腺癌组织中较无淋巴结转移的乳腺癌组织表达升高,且其表达与淋巴结转移数目呈正相关。PRSS22高表达的患者较低表达的患者预后不良,PRSS22是独立预后因子。PRSS22可促进乳腺癌细胞的迁移浸润能力。结论:乳腺癌PRSS22表达升高,其高表达与淋巴结转移、患者预后不良相关。PRSS22有可能成为乳腺癌潜在的生物标志物及治疗靶点。 展开更多
关键词 乳腺肿瘤 PRSS22 淋巴结转移 预后 迁移浸润
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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
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作者 李佳璐 奚菊群 卢丹 《临床和实验医学杂志》 2024年第17期1845-1848,共4页
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(... 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。 展开更多
关键词 乳腺肿瘤 前哨淋巴结活组织检查 预后 分子分型
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Sentinel lymph nodes lymphoscintigraphy and biopsy in breast cancer
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作者 徐敏 刘琳 +1 位作者 孙耘田 陈盛祖 《Chinese Medical Journal》 SCIE CAS CSCD 2002年第8期1137-1140,145-146,共4页
OBJECTIVES: To determine the clinical value of sentinel lymph node (SLN) detection by lympho- scintigraphy and gamma ray detecting probe (GDP) and to assess the value of hematoxylin and eosin (H&E) staining combin... OBJECTIVES: To determine the clinical value of sentinel lymph node (SLN) detection by lympho- scintigraphy and gamma ray detecting probe (GDP) and to assess the value of hematoxylin and eosin (H&E) staining combined with immunohistochemistry (IHC) analys is for detecting micrometastasis in lymph nodes (LNs).  METHODS: Forty-two patients with breast cancer were included in this study. (99)Tc(m)-dextran was injected peritumourally. Lymphoscintigraphy images were obtained in anterior and lateral views. SLNs were removed with the aid of GDP during surgery. A standard axillary lymph nodes (ALNs) dissection was performed. All lymph nodes were first analyzed by HE staining. When all of the SLNs in a patient were negative, the ALNs were subjected to additional HE staining combined with IHC analysis. RESULTS: SLNs were successfully detected and removed in 39 (92.9%) of the 42 patients. The sensitivity, specificity and accuracy of SLN biopsy were 92.9% (13 in 14), 100% (25 in 25) and 97.4% (38 in 39) respectively.  Additional HE staining combined with IHC analysis of the ALNs detected micrometastasis in 3 SLNs (2 cases), but there were no positives in the non-sentinal lymph nodes (NSLNs). CONCLUSIONS: This study suggests that lymphoscintigraphy and GDP may be used to detect SLN. Additional HE staining combined with IHC analysis of the ALNs may help predict micrometastasis. Biopsy of SLN may be an accurate method for staging breast cancer. 展开更多
关键词 Sentinel lymph Node Biopsy ADULT Aged breast neoplasms DEXTRANS FEMALE Humans IMMUNOHISTOCHEMISTRY lymph nodes Middle Aged Organotechnetium Compounds
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血清hMAM、HER2、UBE2C联合检测对乳腺癌腋窝淋巴结转移的诊断价值
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作者 张江华 王海峰 +1 位作者 张克俭 贾国洪 《中国现代普通外科进展》 CAS 2024年第11期856-860,共5页
目的:探究血清人乳腺珠蛋白(hMAM)、人类表皮生长因子受体2(HER2)、泛素结合酶2C(UBE2C)联合检测对乳腺癌腋窝淋巴结转移的诊断价值。方法:选取2022年3月—2024年3月收治的乳腺癌患者90例,根据病理检查结果是否发生腋窝淋巴结转移分为... 目的:探究血清人乳腺珠蛋白(hMAM)、人类表皮生长因子受体2(HER2)、泛素结合酶2C(UBE2C)联合检测对乳腺癌腋窝淋巴结转移的诊断价值。方法:选取2022年3月—2024年3月收治的乳腺癌患者90例,根据病理检查结果是否发生腋窝淋巴结转移分为转移组(n=40)和非转移组(n=50),收集患者的一般临床资料,多因素Logistic回归分析乳腺癌发生腋窝淋巴结转移的影响因素,绘制受试者工作特征(ROC)曲线分析hMAM、HER2、UBE2C对乳腺癌腋窝淋巴结转移的诊断价值,Pearson法分析hMAM、HER2、UBE2C与肿瘤标志物血清白蛋白19(CK19)、癌胚抗原(CEA)及三者间相关性。结果:转移组T_(3)+T_(4)期患者及肿瘤直径>3 cm患者占比显著高于非转移组(P<0.05),转移组水平显著高于非转移组(P<0.05);与非转移组相比,转移组血清hMAM、HER2、UBE2C水平均显著升高(P<0.05);CEA、hMAM、HER2、UBE2C水平升高均为影响乳腺癌发生腋窝淋巴结转移的危险因素(P<0.05);ROC曲线结果显示,hMAM、HER2、UBE2C预测乳腺癌发生腋窝淋巴结转移的AUC分别为0.821、0.815、0.819,三者联合的AUC为0.914,显著高于hMAM(Z=2.070,P=0.038)、HER2(Z=2.072,P=0.038)、UBE2C(Z=1.987,P=0.047)单独诊断。hMAM、HER2、UBE2C与肿瘤检测标志物均呈正相关(P<0.05),且三者之间也均互为正相关(P<0.05)。结论:乳腺癌腋窝淋巴结转移患者的血清hMAM、HER2、UBE2C水平升高,三者联合检测对乳腺癌腋窝淋巴结转移具有一定辅助预测价值,可能作为乳腺癌腋窝淋巴结转移潜在的生物标志物。 展开更多
关键词 人乳腺珠蛋白 人类表皮生长因子受体2 泛素结合酶E2C 乳腺肿瘤 腋窝淋巴结转移
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Using intra-operative GeneSearchTM Breast Lymph Node Assay to detect breast cancer metastases in sentinel lymph nodes: results from a single institute in China 被引量:4
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作者 SUN Xiao LIU Juan-juan +7 位作者 WANG Yong-sheng SONG Xian-rang ZHONG Wei-xia ZHOU Chang-chun MU Dian-bin ZUO Wen-shu YU Zhi-yong ZHOU Zheng-bo 《Chinese Medical Journal》 SCIE CAS CSCD 2011年第7期973-977,共5页
Background Sentinel lymph node (SLN) biopsy has become a common procedure for early breast cancer patients. The GeneSearchTM Breast Lymph Node (BLN) Assay is a real-time RT-PCR assay for the detecting nodal metast... Background Sentinel lymph node (SLN) biopsy has become a common procedure for early breast cancer patients. The GeneSearchTM Breast Lymph Node (BLN) Assay is a real-time RT-PCR assay for the detecting nodal metastases larger than 0.2 mm. China Breast Cancer Clinical Study Group (CBCSG)-001a is a prospective multi-center clinical trial that was conducted to validate the GeneSearchTM BLN Assay in China. 展开更多
关键词 sentinel lymph node biopsy breast neoplasms intraoperative period polymerase chain reaction histological evaluation
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乳腺癌胸肌间淋巴结存在率及阳性率的临床分析 被引量:9
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作者 李涛 谢尚闹 +2 位作者 郑炳初 邹德宏 刘贵森 《中国肿瘤临床》 CAS CSCD 北大核心 2003年第8期564-566,共3页
探讨乳腺癌胸肌间淋巴结(IPNs)存在率、阳性率及其临床意义。方法:对426例行IPNs病理检查的乳腺癌患者,记录其IPNs存在或转移的情况,分析其与年龄、临床分期、病理类型、原发肿瘤的部位、肿块大小、尖群淋巴结的关系。结果:IPNs存在率为... 探讨乳腺癌胸肌间淋巴结(IPNs)存在率、阳性率及其临床意义。方法:对426例行IPNs病理检查的乳腺癌患者,记录其IPNs存在或转移的情况,分析其与年龄、临床分期、病理类型、原发肿瘤的部位、肿块大小、尖群淋巴结的关系。结果:IPNs存在率为21.1%,阳性率为5.9%。IPNs阳性患者原发肿瘤较大,尖群淋巴结阳性率高。结论:IPNs应被重视,在乳腺癌改良根治术中,特别是原发肿瘤较大或可直接触及肿大的胸肌间淋巴结时,IPNs应被清扫并单独送病检。对IPNs重视和正确评价有助于确定更正确的治疗方案,从而可能改善患者预后。 展开更多
关键词 乳腺肿瘤 胸肌 淋巴结
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早期乳腺癌前哨淋巴结活检临床实践指南更新及展望 被引量:13
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作者 周美琪 陈海龙 +2 位作者 胡跃 邓甬川 郑树 《浙江大学学报(医学版)》 CAS CSCD 北大核心 2014年第4期381-387,共7页
腋窝淋巴结是乳腺癌最常见和最先转移的部位,是早期乳腺癌患者重要的独立预后因子。准确的腋窝淋巴结分期对局部治疗的选择、全身综合治疗决策和预后判断等具有重要的指导作用。前哨淋巴结活检(SLNB)是一项腋窝淋巴结准确分期的微创... 腋窝淋巴结是乳腺癌最常见和最先转移的部位,是早期乳腺癌患者重要的独立预后因子。准确的腋窝淋巴结分期对局部治疗的选择、全身综合治疗决策和预后判断等具有重要的指导作用。前哨淋巴结活检(SLNB)是一项腋窝淋巴结准确分期的微创活检技术。循证医学Ⅰ级证据证实,对腋窝淋巴结阴性的患者,SLNB可安全而有效地替代腋窝淋巴结清扫术(ALND),从而显著减少术后并发症发生,改善患者生活质量。但是,SLNB的开展有其特定的适应证和禁忌证,尤其是对于某些特定情况如多灶性或多中心病灶、有既往乳腺活检手术史、新辅助化疗后的乳腺癌患者,临床医师应该遵循指南并结合临床实践综合考虑。通常认为如果SLNB阳性则应该进一步行ALND。随着临床实践的积累和最新临床试验结果的公布,乳腺癌腋窝治疗正从单一的手术治疗走向个体化的多学科干预。充分而准确的术前腋窝淋巴结分期将越来越多原来需行SLNB的腋窝淋巴结阳性患者通过更微创的穿刺活检提前筛选出来,因此SLNB的阳性率将大幅度降低,提示今后部分早期乳癌腋窝处理可能将步入一个免除SLNB的无创时代。本文就SLNB临床实践指南的更新及展望作一综述。 展开更多
关键词 前哨淋巴结活组织检查 乳腺肿瘤/病理学 乳腺肿瘤/外科学 腋/外科学 淋巴结切除术 淋巴结/病理学 综述
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