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[乳腺癌肿瘤大小、淋巴结状态与预后的关系]

[Relation of tumor size, lymph node status and prognosis in breast cancer].

作者信息

Shen Z Z

机构信息

Cancer Hospital, Shanghai Medical University.

出版信息

Zhonghua Wai Ke Za Zhi. 1991 Sep;29(9):554-7, 589.

PMID:1813258
Abstract

Tumor size and the extent of axillary lymph node involvement are the two most important prognostic factors for breast cancer, but their relation is not clear. Data on 2189 cases of radical surgery from 1956-1985 showed a linear relation between tumor size and percentage of cases with positive lymph node involvement. A negative relation was noted between tumor size, the extent of lymph node involvement and prognosis. There was a significance difference in survival rate between one group, two group or more lymph nodes involve. The worst prognosis was seen in those patients with level 3 lymph nodes involve. Tumor size and lymph node status were found to be independent but additive prognostic indicators. If there was no lymph node involvement, the survival rate was decreased because of tumor size. In cases of 1-3 and 4-6 lymph nodes involved, the survival rate was not different when tumor size was less than 5 cm, but there was a significant difference when tumor size large than 5 cm. In cases of more than 7 nodes involved, the survival rate decreased regardless of tumor size. Lymph node metastasis was more important than tumor size in prognosis. The relation of different TNM combination with prognosis was investigated, and the importance of the treatment of internal mammary lymph node in breast cancer was emphasized.

摘要

肿瘤大小和腋窝淋巴结受累程度是乳腺癌最重要的两个预后因素,但它们之间的关系尚不清楚。1956年至1985年2189例根治性手术的数据显示,肿瘤大小与淋巴结受累阳性病例百分比之间呈线性关系。肿瘤大小、淋巴结受累程度与预后呈负相关。一组、两组或更多组淋巴结受累患者的生存率存在显著差异。3级淋巴结受累患者的预后最差。肿瘤大小和淋巴结状态是独立但可相加的预后指标。如果没有淋巴结受累,生存率会因肿瘤大小而降低。在1 - 3个和4 - 6个淋巴结受累的病例中,当肿瘤大小小于5 cm时,生存率没有差异,但当肿瘤大小大于5 cm时,存在显著差异。在超过7个淋巴结受累的病例中,无论肿瘤大小如何,生存率都会降低。淋巴结转移在预后中比肿瘤大小更重要。研究了不同TNM组合与预后的关系,并强调了乳腺癌内乳淋巴结治疗的重要性。

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