| 黄毅,潘艺,李磊,等.腋窝淋巴结阴性乳腺癌 280例腋窝淋巴结转移的危险因素分析[J].安徽医药,2022,26(10):2017-2020. |
| 腋窝淋巴结阴性乳腺癌 280例腋窝淋巴结转移的危险因素分析 |
| Analysis of risk factors for axillary lymph node metastasis in 280 patients with cN0 stage breast cancer |
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| DOI：10.3969/j.issn.1009-6469.2022.10.026 |
| 中文关键词: 乳腺肿瘤 淋巴结切除术 Ki-67抗原 淋巴结阴性 腋窝淋巴结 危险因素 |
| 英文关键词: Breast cancer Lymph node resection Ki-67 antigen cN0 stage Axillary lymph node Risk factors |
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| 中文摘要: |
| 目的探讨临床腋窝淋巴结阴性( cN0期)乳腺癌腋窝淋巴结转移病人的临床病理特征，为病人手术方式选择提供依据。方法选取 2017年 1月至 2019年 12月于黄山市人民医院甲乳外科就诊的 cN0期乳腺癌病人 280例，接受行腋窝前哨淋巴结活检( sentinel lymph node biopsy，SLNB)或腋窝淋巴结清扫( axillary lymph node dissection，ALND)，根据术后腋窝淋巴结病理结果分为阳性组和阴性组，采用单因素分析及 logistic回归分析腋窝淋巴结状态与临床病理特征之间关系。结果 27.86%(78/280)cN0期乳腺癌病人术后病理证实腋窝淋巴结转移，单因素分析提示肿瘤大小、组织学分级、 Ki67水平及脉管瘤栓与腋窝淋巴结转移相关，其中 Ki67低表达阳性 25例、阴性 101例， Ki67高表达阳性 53例、阴性 101例( P<0.05)，多因素分析提示脉管瘤栓和肿瘤 T3期是腋窝淋巴结转移的危险因素［ OR=17.80，4.52。95%CI:(9.07，36.58)(1.09，19.67)］。结论具有脉管瘤栓和 T3的 cN0期乳腺癌病人，腋窝淋巴结转移风险高，可以倾向考虑多种示踪剂联合使用或低位腋窝淋巴结清扫术，更准确评估腋窝淋巴结情况。 |
| 英文摘要: |
| Objective To explore the clinicopathological characteristics of patients with cN0 breast cancer with axillary lymph nodemetastasis and to provide a basis for the selection of surgical methods for patients.Methods A total of 280 patients with cN0 stage breast cancer who were treated in the Department of Breast-Thyroid Surgery of Huangshan City People's Hospital from January 2017 to December 2019 were selected and received axillary sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Ac.cording to the postoperative pathological results of axillary lymph nodes, patients were divided into a positive group and a negativegroup. Univariate analysis and logistic regression were used to analyze the relationship between axillary lymph node status and clinico.pathological characteristics.Results A total of 27.86% (78/280) of patients with stage cN0 breast cancer had axillary lymph node me.tastasis confirmed by postoperative pathology. Univariate analysis showed that tumor size, histological grade, Ki67 level, and vasculartumor thrombus were associated with axillary lymph node metastasis, among which 25 cases with low Ki67 expression were positive and101 cases were negative, and 53 cases were positive and 101 cases had high Ki67 expression (P < 0.05). Multivariate analysis indicatedthat vascular tumor thrombus and T3 stage of tumor were risk factors for axillary lymph node metastasis [OR=17.80,4.52. 95%CI:(9.07, 36.58) (1.09,19.67)].Conclusion Patients with cN0 stage breast cancer with vascular tumor thrombus and T3 have a high risk of axil.lary lymph node metastasis and may be inclined to consider the combined use of multiple tracers or low axillary lymph node dissectionto more accurately assess axillary lymph nodes. |
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