Department of Surgery, Central Hospital, SE-72189 Västerås, Sweden.
J Clin Oncol. 2010 Jun 10;28(17):2868-73. doi: 10.1200/JCO.2009.24.5001. Epub 2010 May 10.
The aim of this study was to determine the prognostic significance of lymph node micrometastases in patients with breast cancer.
Between September 2000 and January 2004, 3,369 patients with breast cancer were included in a prospective cohort. According to their lymph node status, they were classified in the following four groups: 2,383 were node negative, 107 had isolated tumor cells, 123 had micrometastases, and 756 had macrometastases. Median follow-up time was 52 months. Kaplan-Meier estimates and the multivariate Cox proportional hazard regression model were used to analyze survival.
Five-year cause-specific and event-free survival rates were lower for patients with micrometastases (pN1mi) than for node-negative (pN0) patients (94.1% v 96.9% and 79.6% v 87.1%, respectively; P = .020 and P = .032, respectively). There was no significant survival difference between node-negative patients and those with isolated tumor cells. The overall survival of pN1mi and pN0 patients did not differ.
This study demonstrates a worse prognosis for patients with micrometastases than for node-negative patients.
本研究旨在确定乳腺癌患者淋巴结微转移的预后意义。
2000 年 9 月至 2004 年 1 月期间，纳入了 3369 例乳腺癌患者进行前瞻性队列研究。根据其淋巴结状态，将他们分为以下四组：2383 例淋巴结阴性，107 例有孤立肿瘤细胞，123 例有微转移，756 例有宏转移。中位随访时间为 52 个月。采用 Kaplan-Meier 估计和多变量 Cox 比例风险回归模型分析生存情况。
与淋巴结阴性（pN0）患者相比，微转移（pN1mi）患者的 5 年特异性和无事件生存率较低（94.1%对 96.9%和 79.6%对 87.1%；P=.020 和 P=.032）。淋巴结阴性患者与有孤立肿瘤细胞的患者之间的生存差异无统计学意义。pN1mi 和 pN0 患者的总生存率无差异。
本研究表明，与淋巴结阴性患者相比，微转移患者的预后较差。
