354例T1期乳腺癌的淋巴结转移及预后分析

[Lymph node metastasis and prognostic analysis of 354 cases of T1 breast cancer].

作者信息

Lyu Zheng, Wang Jinghua, Kang Lihua, Hu Chunyan, He Hua, Guan Meng, Li Jing, Guan Yanjie, Song Yanqiu

机构信息

Tumor Center, First Affiliated Hospital of Jilin University, Changchun 130021, China.

Email:

出版信息

Zhonghua Zhong Liu Za Zhi. 2014 May;36(5):382-5.

PMID:25030596

Abstract

OBJECTIVE

To analyze the characteristics of lymph node metastasis and prognosis in patients with T1 breast cancer.

METHODS

The clinicopathological data of 354 patients with T1 breast cancer after standard treatment from March 2007 to September 2011 were collected to analyze the relationship between the clinical characteristics of T1 breast cancer, lymph node metastasis and prognostic features.

RESULTS

In the 354 patients with T1 breast cancer, 105 patients (29.7%) had lymph node metastasis, among them 73 cases (69.5%) had 1-3 lymph node metastasis, and 32 cases (30.5%) had more than 4 lymph node metastasis. The lymph node metastasis rate was 8.3% in T1a patients, 39.7% in T1b patients, and 30.4% in T1c cases (P = 0.005). Pairwise comparison showed that the difference of lymph node metastasis rate between T1a, T1b and T1c patients was statistically significant (P = 0.001 and P = 0.006, respectively). The difference of lymph node metastasis rates in T1b and T1c patients was statistically insignificant (P = 0.171). In the 354 patients of T1 breast cancer, 92 patients had vascular tumor thrombi and their lymph node metastasis rate was 71.7%, while the lymph node metastasis rate in 262 patients without vascular tumor thrombus was 14.9% (P < 0.001). The median follow-up was 49 months (range 27-81 months). 12 patients developed recurrence, and 3 patients died, one of them died of cerebrovascular accident. The 4-year disease-free survival for all patients was 96.6%, and the 4-year overall survival rate was 99.2%.

CONCLUSIONS

There is a correlation between vascular tumor thrombus, tumor size and lymph node metastasis rate. The lymph node metastasis rate is lower in T1a patients and relatively higher in T1b/c patients. Compared with patients without vascular tumor thrombus, the T1 breast cancer patients with vascular tumor thrombi have a higher lymph node metastasis rate. Generally speaking, there is a still good prognosis in patients with T1 breast cancer.

摘要

目的

分析T1期乳腺癌患者的淋巴结转移特征及预后情况。

方法

收集2007年3月至2011年9月间354例接受标准治疗后的T1期乳腺癌患者的临床病理资料，分析T1期乳腺癌的临床特征、淋巴结转移及预后特征之间的关系。

结果

354例T1期乳腺癌患者中，105例（29.7%）发生淋巴结转移，其中73例（69.5%）有1 - 3个淋巴结转移，32例（30.5%）有4个以上淋巴结转移。T1a期患者的淋巴结转移率为8.3%，T1b期患者为39.7%，T1c期患者为30.4%（P = 0.005）。两两比较显示，T1a、T1b和T1c期患者之间的淋巴结转移率差异具有统计学意义（分别为P = 0.001和P = 0.006）。T1b期和T1c期患者的淋巴结转移率差异无统计学意义（P = 0.171）。在354例T1期乳腺癌患者中，92例有血管内肿瘤血栓，其淋巴结转移率为71.7%，而262例无血管内肿瘤血栓患者的淋巴结转移率为14.9%（P < 0.001）。中位随访时间为49个月（范围27 - 81个月）。12例患者出现复发，3例死亡，其中1例死于脑血管意外。所有患者的4年无病生存率为96.6%，4年总生存率为99.2%。