Zgajnar Janez, Hocevar Marko, Podkrajsek Maja, Hertl Kristijana, Frkovic-Grazio Snjezana, Vidmar Gaj, Besic Nikola
Department of Surgical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Breast Cancer Res Treat. 2006 Jun;97(3):293-9. doi: 10.1007/s10549-005-9123-6. Epub 2005 Dec 7.
Ultrasound (US) preoperative examination of the axillary lymph nodes combined with the fine needle aspiration biopsy (FNAB) is often used in order to reduce the number of sentinel lymph node (SLN) biopsy procedures in clinically node negative breast cancer patients. The pathohistological characteristics of the ultrasonically negative axillary lymph nodes in clinically negative axillary lymph nodes are not known. The aim of our study was to compare the pathohistological characteristics of ultrasonically uninvolved axillary lymph nodes (US group) versus clinically uninvolved axillary lymph nodes (non-US group) in SLN biopsy candidates.
We included 658 patients after SLN biopsy; 286 patients in the US group and 372 in the non-US group. The pathohistological characteristics of axillary lymph nodes were evaluated by univariate analysis and logistic regression.
In the univariate analysis, the proportion of macrometastastic SLN, total number of metastatic lymph nodes per patient, proportion of nonsentinel lymph node (NSLN) metastases and proportion of NSLN macrometastases were found to be lower in the US group compared to the non-US group. In the logistic regression model, only US of the axilla (p=0.010; OR: 0.57) and tumor size were significant predictors for the presence of SLN macrometastases or macrometastatic NSLN (p<0.001; OR: 0.23).
The patients with US negative axillary lymph nodes form a distinct subgroup of early breast cancer patients having a significantly lower tumor burden in the axillary lymph nodes compared to those with only clinically negative axillary lymph nodes.
超声（US）术前检查腋窝淋巴结并结合细针穿刺活检（FNAB）常用于减少临床腋窝淋巴结阴性乳腺癌患者前哨淋巴结（SLN）活检的次数。临床腋窝淋巴结阴性的超声阴性腋窝淋巴结的病理组织学特征尚不清楚。我们研究的目的是比较前哨淋巴结活检候选者中超声未累及腋窝淋巴结组（US组）与临床未累及腋窝淋巴结组（非US组）的病理组织学特征。
我们纳入了658例行前哨淋巴结活检的患者；US组286例，非US组372例。通过单因素分析和逻辑回归评估腋窝淋巴结的病理组织学特征。
在单因素分析中，发现US组中前哨淋巴结大转移灶的比例、每位患者转移淋巴结的总数、非前哨淋巴结（NSLN）转移的比例以及NSLN大转移灶的比例均低于非US组。在逻辑回归模型中，仅腋窝超声检查（p = 0.010；OR：0.57）和肿瘤大小是前哨淋巴结大转移灶或NSLN大转移灶存在的显著预测因素（p < 0.001；OR：0.23）。
与仅临床腋窝淋巴结阴性的患者相比，超声腋窝淋巴结阴性的患者构成了早期乳腺癌患者的一个独特亚组，其腋窝淋巴结的肿瘤负荷明显更低。
