中华内分泌外科杂志
中華內分泌外科雜誌
중화내분비외과잡지
CHINESE JOURNAL OF ENDOCRINE SURGERY
2012年
5期
307-312
,共6页
邱鹏飞%刘雁冰%王永胜%周正波%赵桐%陈鹏%孙晓%李永清%王春建%张朝蓬%刘广
邱鵬飛%劉雁冰%王永勝%週正波%趙桐%陳鵬%孫曉%李永清%王春建%張朝蓬%劉廣
구붕비%류안빙%왕영성%주정파%조동%진붕%손효%리영청%왕춘건%장조봉%류엄
乳腺癌%前哨淋巴结%MSKCC列线图%预测
乳腺癌%前哨淋巴結%MSKCC列線圖%預測
유선암%전초림파결%MSKCC렬선도%예측
Breast cancer%Sentinel lymph node%MSKCC nomogram%Prediction
目的 探索乳腺癌前哨淋巴结( SLN)转移的危险因素,验证纪念斯隆凯特琳癌症中心(MSKCC)模型的临床应用价值.方法 回顾性分析山东省肿瘤医院2001年12月至2012年1月接受前哨淋巴结活检(SLNB)的1227例乳腺癌,其中412例SLN阳性,通过绘制趋势线和计算ROC曲线下面积( AUG)评估预测准确性,同时分析SLN转移的危险因素.结果 肿瘤大小、位置、组织学分级、脉管侵犯、多灶性、ER和PR与SLN转移明显相关(P＜0.05),除肿瘤位置外均是SLN转移的独立预测因素(P＜0.01).MSKCC模型的AUC值为0.730,预测值≤16％的患者(8.7％,107/1227) SLN阳性率为0.9％,预测值≥70％的患者(4.3％,53/1227) SLN阳性率为96.2％.结论 本研究分析的SLN转移独立预测因素与MSKCC基本一致.MSKCC模型是一种有效的预测SLN转移的工具,预测值≤16％的患者可避免腋窝手术,≥70％的可直接行ALND,其他患者仍应接受SLNB.
目的 探索乳腺癌前哨淋巴結( SLN)轉移的危險因素,驗證紀唸斯隆凱特琳癌癥中心(MSKCC)模型的臨床應用價值.方法 迴顧性分析山東省腫瘤醫院2001年12月至2012年1月接受前哨淋巴結活檢(SLNB)的1227例乳腺癌,其中412例SLN暘性,通過繪製趨勢線和計算ROC麯線下麵積( AUG)評估預測準確性,同時分析SLN轉移的危險因素.結果 腫瘤大小、位置、組織學分級、脈管侵犯、多竈性、ER和PR與SLN轉移明顯相關(P＜0.05),除腫瘤位置外均是SLN轉移的獨立預測因素(P＜0.01).MSKCC模型的AUC值為0.730,預測值≤16％的患者(8.7％,107/1227) SLN暘性率為0.9％,預測值≥70％的患者(4.3％,53/1227) SLN暘性率為96.2％.結論 本研究分析的SLN轉移獨立預測因素與MSKCC基本一緻.MSKCC模型是一種有效的預測SLN轉移的工具,預測值≤16％的患者可避免腋窩手術,≥70％的可直接行ALND,其他患者仍應接受SLNB.
목적 탐색유선암전초림파결( SLN)전이적위험인소,험증기념사륭개특림암증중심(MSKCC)모형적림상응용개치.방법 회고성분석산동성종류의원2001년12월지2012년1월접수전초림파결활검(SLNB)적1227례유선암,기중412례SLN양성,통과회제추세선화계산ROC곡선하면적( AUG)평고예측준학성,동시분석SLN전이적위험인소.결과 종류대소、위치、조직학분급、맥관침범、다조성、ER화PR여SLN전이명현상관(P＜0.05),제종류위치외균시SLN전이적독립예측인소(P＜0.01).MSKCC모형적AUC치위0.730,예측치≤16％적환자(8.7％,107/1227) SLN양성솔위0.9％,예측치≥70％적환자(4.3％,53/1227) SLN양성솔위96.2％.결론 본연구분석적SLN전이독립예측인소여MSKCC기본일치.MSKCC모형시일충유효적예측SLN전이적공구,예측치≤16％적환자가피면액와수술,≥70％적가직접행ALND,기타환자잉응접수SLNB.
Objective To evaluate the risk factors for sentinel lymph node(SLN)metastasis,and assess the value of the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram in predicting SLN metastasis in breast cancer patients.Methods A sentinel lymph node biopsy(SLNB) database containing 1227 consecutive breast cancer patients(412 patients with a positive SLN)was retrospectively analyzed.The value of MSKCC nomogram was predicted by drawing the trend line and calculating the area under the curve(AUC) of receiver-operator characteristic(ROC). Meanwhile,the risk factors of SLN metastasis were evaluated. Results Tumor size,tumor location,histological grade,lymphovascular invasion,mulifocality,ER and PR status were correlated with SLN metastasis( all P ＜ 0.05 ).All the above factors but tumor location were significant independent predictors for SLN metastasis(all P ＜ 0.01 ).The MSKCC nomogram presented AUC value of 0.730 for ROC.Patients with predictive values lower than 16％ had the frequency of 0.9％ for SLN metastasis while patients with predictive values higher than 70％ had the frequency of 96.2％.Conclusions The risk factors of SLN metastasis in our study are consistent with those in MSKCC nomogram.MSKCC nomogram is a useful tool in predicting the probability of SLN metastasis for breast cancer patients.Axillary surgery can be avoided in patients with the predictive values lower than 16％,axillary lymph node dissection could be done in patients with the predictive values higher than 70％,and other patients should still undergo SLNB.
