Breast Cancer Center, Shandong Cancer Hospital 440 Jiyan Rd, Jinan, Shandong, 250117, PR China.
Jpn J Clin Oncol. 2012 Nov;42(11):1002-7. doi: 10.1093/jjco/hys150.
To evaluate the risk factors for sentinel lymph node metastasis and validate the value of the Memorial Sloan-Kettering Cancer Center nomogram for the prediction of sentinel lymph node metastasis in breast cancer patients.
A sentinel lymph node biopsy database containing 1227 consecutive breast cancer patients (416 patients with at least one positive sentinel lymph node) was retrospectively analyzed. The predictive value of the Memorial Sloan-Kettering Cancer Center nomogram was calculated by the trend line and the area under the receiver-operator characteristic curve. Meanwhile, predictors for sentinel lymph node metastasis were also evaluated.
Tumor size, histological grade, lymphovascular invasion, mulifocality, estrogen receptor and progesterone receptor status were significant independent predictors for sentinel lymph node metastasis (all P<0.01). The Memorial Sloan-Kettering Cancer Center nomogram presented an area under the receiver-operator characteristic curve value of 0.730. Patients with predictive value<16% had a frequency of sentinel lymph node metastasis of 0.9%. Those with values larger than 70% had a frequency of 96.2%.
The risk factors for sentinel lymph node metastasis in our study were consistent with those in the Memorial Sloan-Kettering Cancer Center nomogram. The Memorial Sloan-Kettering Cancer Center nomogram is a useful tool that could accurately predict the probability of sentinel lymph node metastasis in our breast cancer patients. Axillary surgical staging might be avoided in patients with a predictive value of <16% and axillary lymph node dissection might be done directly in those with a predictive value >70%, while other patients should still accept sentinel lymph node biopsy.
评估前哨淋巴结转移的危险因素,并验证纪念斯隆-凯特琳癌症中心列线图预测乳腺癌患者前哨淋巴结转移的价值。
回顾性分析了包含 1227 例连续乳腺癌患者(416 例至少有 1 个前哨淋巴结阳性)的前哨淋巴结活检数据库。通过趋势线和接受者操作特征曲线下的面积计算纪念斯隆-凯特琳癌症中心列线图的预测价值。同时,还评估了前哨淋巴结转移的预测因素。
肿瘤大小、组织学分级、脉管侵犯、多灶性、雌激素受体和孕激素受体状态是前哨淋巴结转移的显著独立预测因素(均 P<0.01)。纪念斯隆-凯特琳癌症中心列线图的接受者操作特征曲线下面积值为 0.730。预测值<16%的患者前哨淋巴结转移的频率为 0.9%。那些预测值大于 70%的患者的转移频率为 96.2%。
本研究中前哨淋巴结转移的危险因素与纪念斯隆-凯特琳癌症中心列线图中的危险因素一致。纪念斯隆-凯特琳癌症中心列线图是一种有用的工具,可以准确预测我们的乳腺癌患者前哨淋巴结转移的概率。预测值<16%的患者可能避免腋窝手术分期,预测值>70%的患者可能直接进行腋窝淋巴结清扫,而其他患者仍应接受前哨淋巴结活检。