Geneva University Hospitals, Geneva, Switzerland.
Future Oncol. 2009 Dec;5(10):1585-603. doi: 10.2217/fon.09.129.
The number of positive axillary nodes is a strong prognostic factor in breast cancer, but is affected by variability in nodal staging technique yielding varying numbers of excised nodes. The nodal ratio of positive to excised nodes is an alternative that could address this variability. Our 2006 review found that the nodal ratio consistently outperformed the number of positive nodes, providing strong arguments for the use of nodal ratios in breast cancer staging and management. New evidence has continued to accrue confirming the prognostic significance of nodal ratios in various worldwide population settings. This review provides an updated summary of available data, and discusses the potential application of the nodal ratio to breast cancer staging and prognostication, its role in the context of modern surgical techniques such as sentinel node biopsy, and its potential correlations with new biologic markers such as circulating tumor cells and breast cancer stem cells.
腋窝淋巴结阳性的数量是乳腺癌的一个强有力的预后因素，但受淋巴结分期技术的变异性影响，导致切除的淋巴结数量不同。阳性淋巴结与切除淋巴结的比值是一种可以解决这种变异性的替代方法。我们 2006 年的综述发现，淋巴结比值始终优于阳性淋巴结的数量，为在乳腺癌分期和管理中使用淋巴结比值提供了强有力的论据。新的证据不断积累，证实了淋巴结比值在各种全球人群中的预后意义。这篇综述提供了对现有数据的最新总结，并讨论了淋巴结比值在乳腺癌分期和预后中的潜在应用，以及其在现代外科技术（如前哨淋巴结活检）背景下的作用，及其与循环肿瘤细胞和乳腺癌干细胞等新的生物学标志物的潜在相关性。
