中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
34期
2661-2664
,共4页
杨飏%何英剑%李金峰%解云涛%王天峰%范照青%范铁%欧阳涛
楊飏%何英劍%李金峰%解雲濤%王天峰%範照青%範鐵%歐暘濤
양양%하영검%리금봉%해운도%왕천봉%범조청%범철%구양도
乳腺肿瘤%前哨淋巴结活组织检查%预测模型
乳腺腫瘤%前哨淋巴結活組織檢查%預測模型
유선종류%전초림파결활조직검사%예측모형
Breast neoplasms%Sentinel lymph node biopsy%Predictive model
目的 探讨前哨淋巴结(SLN)阳性乳腺癌新辅助化疗后非前哨淋巴结(NSLN)状态的影响因素并建立非前哨淋巴结状态的预测模型.方法 选取北京肿瘤医院乳腺癌预防治疗中心数据库2005年8月至2013年3月SLN阳性并接受新辅助化疗的乳腺癌病例512例,探讨NSLN状态的影响因素,建立预测模型并评价预测价值.结果 腋窝淋巴结清扫后共115例(22.4％)病例NSLN存在转移.单因素分析中,患者肿瘤大小、SLN阳性数、激素受体(HR)、微转移、化疗临床评效是NSLN状态的影响因素,差异有统计学意义(P＜0.05).多因素分析中,肿瘤大小、HR、SLN阳性数、微转移和化疗临床评效是NSLN状态的独立预测因子.ROC曲线下面积为0.779(95％ CI:0.732 ～0.825).结论 患者年龄、肿瘤大小、SLN阳性数、微转移和化疗临床评效是化疗后病例NSLN状态的独立预测因子.据此建立的模型的预测价值有待进一步验证.
目的 探討前哨淋巴結(SLN)暘性乳腺癌新輔助化療後非前哨淋巴結(NSLN)狀態的影響因素併建立非前哨淋巴結狀態的預測模型.方法 選取北京腫瘤醫院乳腺癌預防治療中心數據庫2005年8月至2013年3月SLN暘性併接受新輔助化療的乳腺癌病例512例,探討NSLN狀態的影響因素,建立預測模型併評價預測價值.結果 腋窩淋巴結清掃後共115例(22.4％)病例NSLN存在轉移.單因素分析中,患者腫瘤大小、SLN暘性數、激素受體(HR)、微轉移、化療臨床評效是NSLN狀態的影響因素,差異有統計學意義(P＜0.05).多因素分析中,腫瘤大小、HR、SLN暘性數、微轉移和化療臨床評效是NSLN狀態的獨立預測因子.ROC麯線下麵積為0.779(95％ CI:0.732 ～0.825).結論 患者年齡、腫瘤大小、SLN暘性數、微轉移和化療臨床評效是化療後病例NSLN狀態的獨立預測因子.據此建立的模型的預測價值有待進一步驗證.
목적 탐토전초림파결(SLN)양성유선암신보조화료후비전초림파결(NSLN)상태적영향인소병건립비전초림파결상태적예측모형.방법 선취북경종류의원유선암예방치료중심수거고2005년8월지2013년3월SLN양성병접수신보조화료적유선암병례512례,탐토NSLN상태적영향인소,건립예측모형병평개예측개치.결과 액와림파결청소후공115례(22.4％)병례NSLN존재전이.단인소분석중,환자종류대소、SLN양성수、격소수체(HR)、미전이、화료림상평효시NSLN상태적영향인소,차이유통계학의의(P＜0.05).다인소분석중,종류대소、HR、SLN양성수、미전이화화료림상평효시NSLN상태적독립예측인자.ROC곡선하면적위0.779(95％ CI:0.732 ～0.825).결론 환자년령、종류대소、SLN양성수、미전이화화료림상평효시화료후병례NSLN상태적독립예측인자.거차건립적모형적예측개치유대진일보험증.
Objective To evaluate the risk factors for non-sentinel lymph node(NSLN) metastasis in patients after neoadjuvant chemotherapy (NCT)so as to develop a new predictive model.Methods A total of 512 consecutive patients with metastasis in sentinel lymph node(SLN) on neoadjuvant chemotherapy between August 2005 and March 2013 were recruited to evaluate the factors affecting the involvement of NSLN.Logistic regression analysis was performed to construct a predictive model.Results There were 115 (22.4％) patients with metastasis in NSLN after axillary lymph node dissection.Univariate analysis showed that tumor size,number of positive SLN,hormone receptor(HR),micrometastasis and clinical response of primary tumor after NCT were associated with the involvement of NSLN (P ＜ 0.05).Multivariate analysis indicated that tumor size,number of positive SLN,HR,micrometastasis and clinical response of primary tumor after NCT were significant independent predictors for NSLN metastasis.Area under the curve was 0.779.Conclusion Tumor size,number of positive SLN,HR,micrometastasis and clinical response of primary tumor after NCT were significant independent predictors for NSLN metastasis in patients after NCT.The new model is to be further validated.
