评估前哨淋巴结转移的乳腺癌患者非前哨淋巴结状态的预测因素。

Predictors to assess non-sentinel lymph node status in breast cancer patients with sentinel lymph node metastasis.

作者信息

Jinno Hiromitsu, Sakata Michio, Asaga Sota, Wada Masahiro, Shimada Toshiyuki, Kitagawa Yuko, Suzuki Takayuki, Nakahara Tadaki, Kitamura Naoto, Kubo Atsushi, Mukai Makio, Ikeda Tadashi, Kitajima Masaki

机构信息

Department of Surgery, Keio University School of Medicine, Tokyo, Japan.

出版信息

Breast J. 2008 Nov-Dec;14(6):551-5. doi: 10.1111/j.1524-4741.2008.00646.x. Epub 2008 Oct 13.

DOI:10.1111/j.1524-4741.2008.00646.x

PMID:19000054

Abstract

The next step of sentinel lymph node biopsy (SLNB) in breast cancer is to determine which patients need axillary lymph node dissection (ALND) following a positive SLNB. A prospective database of 239 patients who underwent SLNB followed by complete ALND at Keio University Hospital from January 2001 to June 2005 was reviewed. A total of 131 patients with one or more positive sentinel lymph nodes (SLNs) were further analyzed. A univariate analysis showed a significant correlation between non-SLN involvement and lymphatic invasion, vascular invasion, number of tumor-involved SLNs, radioactivity of SLNs, and size of SLN metastasis (p = 0.0002, p = 0.004, p = 0.006, p = 0.04, p = 0.03, respectively). By multivariate analysis, lymphatic invasion and the number of tumor-involved SLNs remained significant predictors of non-SLN involvement. In breast cancer patients with a positive SLN, lymphatic invasion and the number of tumor-involved SLNs were both independent predictors of non-SLN involvement.

摘要

乳腺癌前哨淋巴结活检（SLNB）的下一步是确定哪些患者在SLNB结果为阳性后需要进行腋窝淋巴结清扫（ALND）。回顾了一个前瞻性数据库，该数据库包含2001年1月至2005年6月在庆应义塾大学医院接受SLNB并随后进行完整ALND的239例患者。对总共131例有一个或多个前哨淋巴结（SLN）阳性的患者进行了进一步分析。单因素分析显示，非前哨淋巴结受累与淋巴管浸润、血管浸润、受累SLN的数量、SLN的放射性以及SLN转移灶大小之间存在显著相关性（p值分别为0.0002、0.004、0.006、0.04、0.03）。多因素分析表明，淋巴管浸润和受累SLN的数量仍然是非前哨淋巴结受累的显著预测因素。在SLN阳性的乳腺癌患者中，淋巴管浸润和受累SLN的数量都是非前哨淋巴结受累的独立预测因素。