CAJ | 학술논문

目的：探讨锁骨下淋巴结清扫对乳腺癌腋窝淋巴结阳性患者预后的影响。方法将158例腋窝淋巴结阳性乳腺癌患者随机分为锁骨下淋巴结未清扫组（ A组）和锁骨下淋巴结清扫组（ B组），分别用Kaplan-Meier法和Cox风险模型对两组临床病理因素与患者无病生存（ DFS）时间的关系进行单因素和多因素生存分析。结果单因素和多因素分析均显示，患者的中位DFS时间与肿瘤大小、腋窝淋巴结阳性比率、人类表皮生长因子受体2（ HER-2）表达状态及锁骨下淋巴结是否清扫显著性相关（P均＜0．05）。结论对乳腺癌腋窝淋巴结阳性患者中原发肿瘤＞5 cm、HER-2高表达状态或腋窝淋巴结转移率＞0．4者进行锁骨下淋巴结清扫，可使其DFS明显延长。
목적：탐토쇄골하림파결청소대유선암액와림파결양성환자예후적영향。방법장158례액와림파결양성유선암환자수궤분위쇄골하림파결미청소조（ A조）화쇄골하림파결청소조（ B조），분별용Kaplan-Meier법화Cox풍험모형대량조림상병리인소여환자무병생존（ DFS）시간적관계진행단인소화다인소생존분석。결과단인소화다인소분석균현시，환자적중위DFS시간여종류대소、액와림파결양성비솔、인류표피생장인자수체2（ HER-2）표체상태급쇄골하림파결시부청소현저성상관（P균＜0．05）。결론대유선암액와림파결양성환자중원발종류＞5 cm、HER-2고표체상태혹액와림파결전이솔＞0．4자진행쇄골하림파결청소，가사기DFS명현연장。
Objective To investigate the influence of subclavian lymph node dissection on the prognosis of breast cancer patients with positive axillary lymph nodes .Methods Totally 158 breast cancer patients with positive axillary lymph nodes were divided into two groups:group A ( subclavian lymph nodes were not dissected ) and group B ( subclavian lymph nodes were dissected ) .The clinic pathological features of the two groups were compared .Kaplan-Meier method and Cox proportional hazard method were respectively used to make univariate and multivariate survival analysis for disease -free sur-vival ( DFS) .Results Univariate and multivariate survival analysis showed that tumor size , lymph nodes metastasis rate , the level of HER-2 expression and the dissection of subclavian lymph nodes were factors that influenced DFS ( all P<0.05).Conclusion Subclavian lymph node dissection in breast cancer patients with positive axillary lymph node is rec -ommended for patients whose tumor size is more than 5cm, the lymph node metastasis rate is more than 0.4 and the level of HER-2 expression is high .