Sun Jing-Yan, Ning Lian-Sheng
Department of Breast Surgery, Cancer Hospital, Tianjin Medical University, Tianjin 300060, China.
Zhonghua Zhong Liu Za Zhi. 2008 May;30(5):352-5.
To analyze the clinicopathologic characteristics and the prognostic factors of breast cancer patients with skip metastases in the axilla.
The clinical data of 1502 breast cancer patients who underwent complete axillary lymph node dissection were retrospectively reviewed. The patterns of skip metastases, clinical features and prognostic factors were analyzed.
Of the 1502 patients, lymph node metastases were found in 814, of whom skip metastases in 119 (14.6%, 119/814). The Clinicopathologic factors such as age, tumor size, tumor location, clinical stage, hormonal receptor status and involved interpectoral lymph nodes were not correlated with skip metastases (P > 0.05). The disease free survival rate was lower in clinical stage I and II patients with skip metastases than that in those without (P = 0.003), while no significant difference was observed in clinical stage III patients (P = 0.457). Multivariate analysis showed that the tumor size, number of metastatic lymph nodes, extracapsular invasion of the lymph nodes and skip metastases in the axilla were significantly correlated with survival rate.
Skip metastasis in the axilla cannot be accurately predicted by clinicopathologic factors. Early breast cancer patients with skip metastases should be treated properly due to poor prognosis.
分析腋窝存在跳跃转移的乳腺癌患者的临床病理特征及预后因素。
回顾性分析1502例行腋窝淋巴结清扫术的乳腺癌患者的临床资料。分析跳跃转移模式、临床特征及预后因素。
1502例患者中，814例发现有淋巴结转移，其中119例（14.6%，119/814）存在跳跃转移。年龄、肿瘤大小、肿瘤位置、临床分期、激素受体状态及胸肌间淋巴结受累等临床病理因素与跳跃转移无关（P>0.05）。有跳跃转移的Ⅰ期和Ⅱ期临床患者的无病生存率低于无跳跃转移者（P = 0.003），而Ⅲ期临床患者未观察到显著差异（P = 0.457）。多因素分析显示，肿瘤大小、转移淋巴结数量、淋巴结包膜外侵犯及腋窝跳跃转移与生存率显著相关。
临床病理因素无法准确预测腋窝跳跃转移。腋窝有跳跃转移的早期乳腺癌患者预后较差，应给予恰当治疗。
