基于1656例患者的结果，淋巴结比率在不同乳腺癌亚型中相对于pN分期的额外预后价值。

Additional prognostic value of lymph node ratio over pN staging in different breast cancer subtypes based on the results of 1,656 patients.

作者信息

Ataseven B, Kümmel S, Weikel W, Heitz F, Holtschmidt J, Lorenz-Salehi F, Kümmel A, Traut A, Blohmer J, Harter P, du Bois A

机构信息

Department of Gynecology and Gynecologic Oncology, Evangelische Huyssens-Stiftung, Kliniken Essen-Mitte, Essen, Germany,

出版信息

Arch Gynecol Obstet. 2015 May;291(5):1153-66. doi: 10.1007/s00404-014-3528-6. Epub 2014 Nov 5.

DOI:10.1007/s00404-014-3528-6

PMID:25367604

Abstract

PURPOSE

Although the impact of lymph node ratio (LNR: ratio of metastatic to resected LNs) in breast cancer (BC) has been investigated, its prognostic value in molecular subtypes remains unclear. Our aim was to evaluate the impact of LNR compared to pN-stage in BC subtypes.

PATIENTS/METHODS: We analyzed the impact of LNR and pN-stage on disease-free (DFS) and overall survival (OS) in 1,656 patients with primary BC who underwent primary axillary surgery (removal of ≥10 LNs) between 1998 and 2011. The cut-off points for LNR were previously published. Using immunohistochemical parameters tumors were grouped in luminalA, luminalB/HER2-, luminalB/HER2+, HER2+ and triple negative (TNBC).

RESULTS

For the entire cohort 5/10-year DFS and OS rates were 88/77% and 88/75%, respectively. LNR and pN-stage were independent prognostic parameters for DFS/OS in multivariate analysis in the entire cohort and each molecular subgroup (p < 0.001). However, increasing LNR seemed to discriminated 10-year DFS slightly better than pN-stage in luminalA (intermediate/high LNR 65/44% versus pN2/pN3 71/53%), luminalB/HER2- (intermediate/high LNR 48/24% versus pN2/pN3 41/42%), and TNBC patients (intermediate/high LNR 49/24% versus pN2/pN3 56/33%).

CONCLUSIONS

LNR is an important prognostic parameter for DFS/OS and might provide potentially more information than pN-stage in different molecular subtypes.

摘要

目的

尽管已经研究了淋巴结比率（LNR：转移淋巴结与切除淋巴结的比率）对乳腺癌（BC）的影响，但其在分子亚型中的预后价值仍不清楚。我们的目的是评估BC亚型中LNR与pN分期相比的影响。

患者/方法：我们分析了1998年至2011年间接受原发性腋窝手术（切除≥10个淋巴结）的1656例原发性BC患者中LNR和pN分期对无病生存期（DFS）和总生存期（OS）的影响。LNR的截断点先前已公布。利用免疫组化参数，将肿瘤分为腔面A型、腔面B/HER2阴性型、腔面B/HER2阳性型、HER2阳性型和三阴性（TNBC）型。

结果

对于整个队列，5/10年DFS和OS率分别为88/77%和88/75%。在整个队列和每个分子亚组的多变量分析中，LNR和pN分期是DFS/OS的独立预后参数（p<0.001）。然而，在腔面A型（中/高LNR为65/44%，而pN2/pN3为71/53%）、腔面B/HER2阴性型（中/高LNR为48/24%，而pN2/pN3为41/42%）和TNBC患者（中/高LNR为49/24%，而pN2/pN3为56/33%）中，LNR升高似乎比pN分期对10年DFS的区分度稍好。