CAJ | 학술논문

目的探讨乳腺癌肌间淋巴结（IPN）转移的高危因素。方法收集行乳腺癌改良根治术的782例患者（均行IPN切除）的资料，选择年龄、肿瘤位置、肿瘤大小、腋窝淋巴结转移、脉管（血管、淋巴管）侵犯、病理类型、分子分型、Ki-67共8个乳腺癌内乳淋巴结转移可能相关的因素，分析不同情况下IPN转移的高危因素。结果全组患者IPN检出率21.0%，转移率6.9%；单因素分析显示，IPN的转移与肿瘤大小、腋窝淋巴结转移数目、脉管（血管、淋巴管）侵犯、病理类型、Ki-67明显相关（P＜0.05）,而与年龄、肿瘤位置及分子分型无明显关系（P＞0.05）。logistic多因素回归分析显示，仅腋窝淋巴结转移和脉管侵犯是IPN转移的独立高危因素（均P＜0.01），其中腋窝淋巴转移是最重要的危险因素。结论肿瘤大小、腋窝淋巴结转移、脉管（血管、淋巴管）侵犯、病理类型、Ki-67是乳腺癌IPN转移的危险因素，腋窝淋巴结转移及脉管侵犯与否是影响IPN转移的独立高危因素。
목적탐토유선암기간림파결（IPN）전이적고위인소。방법수집행유선암개량근치술적782례환자（균행IPN절제）적자료，선택년령、종류위치、종류대소、액와림파결전이、맥관（혈관、림파관）침범、병리류형、분자분형、Ki-67공8개유선암내유림파결전이가능상관적인소，분석불동정황하IPN전이적고위인소。결과전조환자IPN검출솔21.0%，전이솔6.9%；단인소분석현시，IPN적전이여종류대소、액와림파결전이수목、맥관（혈관、림파관）침범、병리류형、Ki-67명현상관（P＜0.05）,이여년령、종류위치급분자분형무명현관계（P＞0.05）。logistic다인소회귀분석현시，부액와림파결전이화맥관침범시IPN전이적독립고위인소（균P＜0.01），기중액와림파전이시최중요적위험인소。결론종류대소、액와림파결전이、맥관（혈관、림파관）침범、병리류형、Ki-67시유선암IPN전이적위험인소，액와림파결전이급맥관침범여부시영향IPN전이적독립고위인소。
Objective To assess the risk factors of interpectoral lymph nodes metastasis in breast cancer patients. Methods The clinical data of 782 breast cancer patients, who underwent modified radical mastectomy with interpectoral lymph nodes removed, were analyzed retrospectively. Eight individual variables, including age, tumor site, tumor size, axil ary node metastasis status, vascular invasion, pathological type, molecular classification and Ki- 67 expression were selected for investi-gating high risk factors of interpectoral lymph node metastasis. Results The detection rate and metastasis rate of interpectoral lymph nodes were 21.0%and 6.9%, respectively. Univariate analysis showed that patient age, tumor site, molecular classification were not significantly correlated with metastasis of interpectoral lymph nodes in breast cancer (P>0.05). Tumor size, axil ary nodes metastasis status, vascular invasion, pathological type and Ki- 67 expression were positively associated with metastasis of interpectoral lymph nodes (P<0.05). Multivariate logistic regression showed that vascular invasion and axil ary nodes metastasis were independent risk factors for interpectoral lymph node metastasis in breast cancer (P<0.01). Conclusion The tumor size, axil ary nodes metastasis status, vascular invasion, pathological type and Ki- 67 are among the risk factors of interpectoral lymph nodes metastasis in breast cancer, however, only the vascular invasion and axil ary nodes metastasis are independent risk fac-tors.