中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
30期
2355-2358
,共4页
高雅军%何英剑%范照青%欧阳涛
高雅軍%何英劍%範照青%歐暘濤
고아군%하영검%범조청%구양도
乳腺肿瘤%前哨淋巴结活检%淋巴转移%危险因素
乳腺腫瘤%前哨淋巴結活檢%淋巴轉移%危險因素
유선종류%전초림파결활검%림파전이%위험인소
Breast neoplasms%Sentinel lymph node biopsy%Lymphatic metastasis%Risk factors
目的 回顾性分析阳性前哨淋巴结≤2枚乳腺癌非前哨淋巴结状态相关的因素,探索预测其非前哨淋巴结(NSLN)状态的可能性.方法 采用北京肿瘤医院乳腺癌预防治疗中心数据库资料,分析2005年7月至2012年2月期间,阳性前哨淋巴结≤2枚并完成腋窝淋巴结清扫且排除SLNB后新辅助化疗不足4轮或行新辅助内分泌治疗的乳腺癌病例资料,分析其非前哨淋巴结状态影响因素.结果 455例患者病历资料纳入分析,单因素分析有统计学意义或接近有统计学意义的因素有前哨淋巴结(SLN)(+)/SLN比值(P =0.001),组织学分级(P =0.075),肿物大小(P=0.023)以及发病年龄(P =0.074);多因素Logistic回归分析得出SLN(+)/SLN比值(OR0.502 95％ CI0.322～0.7844)和组织学分级(组织学分级Ⅱ、Ⅲ级及其他类型比较组织学分级Ⅰ级的OR值分别为2.696,2.102,3.662)是NSLN的独立影响因素.ROC曲线下面积为0.62(0.56,0.68),预测NSLN效果不佳.结论 对于阳性前哨淋巴结≤2的乳腺癌,SLN(+)/SLN比值及病理组织学分级是NSLN状态的独立影响因素,但预测NSLN结果效果不佳.
目的 迴顧性分析暘性前哨淋巴結≤2枚乳腺癌非前哨淋巴結狀態相關的因素,探索預測其非前哨淋巴結(NSLN)狀態的可能性.方法 採用北京腫瘤醫院乳腺癌預防治療中心數據庫資料,分析2005年7月至2012年2月期間,暘性前哨淋巴結≤2枚併完成腋窩淋巴結清掃且排除SLNB後新輔助化療不足4輪或行新輔助內分泌治療的乳腺癌病例資料,分析其非前哨淋巴結狀態影響因素.結果 455例患者病歷資料納入分析,單因素分析有統計學意義或接近有統計學意義的因素有前哨淋巴結(SLN)(+)/SLN比值(P =0.001),組織學分級(P =0.075),腫物大小(P=0.023)以及髮病年齡(P =0.074);多因素Logistic迴歸分析得齣SLN(+)/SLN比值(OR0.502 95％ CI0.322～0.7844)和組織學分級(組織學分級Ⅱ、Ⅲ級及其他類型比較組織學分級Ⅰ級的OR值分彆為2.696,2.102,3.662)是NSLN的獨立影響因素.ROC麯線下麵積為0.62(0.56,0.68),預測NSLN效果不佳.結論 對于暘性前哨淋巴結≤2的乳腺癌,SLN(+)/SLN比值及病理組織學分級是NSLN狀態的獨立影響因素,但預測NSLN結果效果不佳.
목적 회고성분석양성전초림파결≤2매유선암비전초림파결상태상관적인소,탐색예측기비전초림파결(NSLN)상태적가능성.방법 채용북경종류의원유선암예방치료중심수거고자료,분석2005년7월지2012년2월기간,양성전초림파결≤2매병완성액와림파결청소차배제SLNB후신보조화료불족4륜혹행신보조내분비치료적유선암병례자료,분석기비전초림파결상태영향인소.결과 455례환자병력자료납입분석,단인소분석유통계학의의혹접근유통계학의의적인소유전초림파결(SLN)(+)/SLN비치(P =0.001),조직학분급(P =0.075),종물대소(P=0.023)이급발병년령(P =0.074);다인소Logistic회귀분석득출SLN(+)/SLN비치(OR0.502 95％ CI0.322～0.7844)화조직학분급(조직학분급Ⅱ、Ⅲ급급기타류형비교조직학분급Ⅰ급적OR치분별위2.696,2.102,3.662)시NSLN적독립영향인소.ROC곡선하면적위0.62(0.56,0.68),예측NSLN효과불가.결론 대우양성전초림파결≤2적유선암,SLN(+)/SLN비치급병리조직학분급시NSLN상태적독립영향인소,단예측NSLN결과효과불가.
Objective To explore retrospectively the risk factors of non-sentinel lymph node (NSLN) metastasis in breast cancer patients with sentinel lymph node metastasis ≤ 2 and examine the likelihood of non-sentinel lymph node prediction.Methods A sentinel lymph node biopsy database containing 455 breast cancer patients admitted between July 2005 and February 2012 at Beijing Cancer Hospital was analyzed retrospectively.The patients had ≤ 2 positive sentinel lymph node and complete axillary lymph node dissection.Results The SLNS (+)/SLNS ratio (P =0.001),histological grade (P =0.075),size of mass (P =0.023) and onset age (P =0.074) were correlated with NSLN metastases.Only SLNS (+)/SLNS(OR 0.502 95％ CI 0.322-0.7844),histological grade ratio (histological grade ratio Ⅱ,Ⅲ and others vs grade Ⅰ OR 2.696,2.102,3.662)were significant independent predictors for NSLN metastases.The ROC value was 0.62 (0.56,0.68).Conclusions For ≤ 2 positive sentinel lymph nodes of breast cancer,ratio of SLNS (+)/SLNS and histological grading are independent factors affecting NSLN metastases.However,the results remain unsatisfactory for predicting the status of NSLN.
