Wu San-Gang, Sun Jia-Yuan, Zhou Juan, Li Feng-Yan, Lin Qin, Lin Huan-Xin, Guan Xun-Xing, He Zhen-Yu
Xiamen Cancer Center, Department of Radiation Oncology, the First Affiliated Hospital of Xiamen University, Xiamen, 361003, People's Republic of China.
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China.
BMC Cancer. 2015 Feb 7;15:43. doi: 10.1186/s12885-015-1061-z.
The aim of this study was to evaluate the prognostic value of the number of negative lymph nodes (NLNs) in breast cancer patients after mastectomy.
2,455 breast cancer patients who received a mastectomy between January 1998 and December 2007 were retrospectively reviewed. The prognostic impact of the number of NLNs with respect to disease-free survival (DFS) was analyzed.
The median follow-up time was 62.0 months, and the 5-year and 10-year DFS was 87.1% and 74.3%, respectively. The DFS of patients with >10 NLNs was significantly higher than that of patents with ≤10 NLNs, and the 5-year DFS rates were 87.5% and 69.5%, respectively (P < 0.001). Univariate Cox analysis showed that the NLN count (continuous variable) was a prognostic factor of DFS (hazard ratio [HR] = 0.913, 95% confidence interval [CI]: 0.896-0.930, P < 0.001). In multivariate Cox analysis, patients with a higher number of NLNs had a better DFS (HR = 0.977, 95% CI: 0.958-0.997, P = 0.022). Subgroup analysis showed that the NLN count had a prognostic value in patients at different pT stages and pN positive patients (log-rank P < 0.001). However, it had no prognostic value in pN0 patients (log-rank P = 0.684).
The number of NLNs is an independent prognostic factor of DFS in breast cancer patients after mastectomy, and patients with a higher number of NLNs have a better DFS.
本研究旨在评估乳房切除术后乳腺癌患者阴性淋巴结数量（NLNs）的预后价值。
回顾性分析了1998年1月至2007年12月期间接受乳房切除术的2455例乳腺癌患者。分析了NLNs数量对无病生存期（DFS）的预后影响。
中位随访时间为62.0个月，5年和10年DFS分别为87.1%和74.3%。NLNs>10个的患者DFS显著高于NLNs≤10个的患者，5年DFS率分别为87.5%和69.5%（P<0.001）。单因素Cox分析显示，NLN计数（连续变量）是DFS的预后因素（风险比[HR]=0.913，95%置信区间[CI]：0.896-0.930，P<0.001）。多因素Cox分析显示，NLNs数量较多的患者DFS较好（HR=0.977，95%CI：0.958-0.997，P=0.022）。亚组分析显示，NLN计数在不同pT分期患者和pN阳性患者中具有预后价值（对数秩检验P<0.001）。然而，在pN0患者中它没有预后价值（对数秩检验P=0.684）。
NLNs数量是乳房切除术后乳腺癌患者DFS的独立预后因素，NLNs数量较多的患者DFS较好。
