Kondov Borislav, Kondov Goran, Spirovski Zoran, Milenkovikj Zvonko, Colanceski Risto, Petrusevska Gordana, Pesevska Meri
University Clinic for Thoracic and Vascular Surgery, Skopje, Majka Tereza 17, 1000 Skopje.
University Clinic for Thoracic and Vascular Surgery - Medical Faculty Skopje.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2017 Mar 1;38(1):81-90. doi: 10.1515/prilozi-2017-0011.
The aim of the study was to identify the impact of T stage, the presence of estrogen, progesterone, HER2neu receptors and the values of the Ki67 on the positivity for metastases of the axillary lymph nodes, from primary breast cancer.
290 surgically treated patients for breast cancer were included in the study. All cases have been analyzed by standard histological analysis including microscopic analysis on standard H&E staining. For determining the molecular receptors - HER2neu, ER, PR, p53 and Ki67, immunostaining by PT LINK immunoperoxidase has been done.
Patients age was ranged between 18-90 years, average of 57.6+11.9. The mean size of the primary tumor in the surgically treated patient was 30.27 + 18.3 mm. On dissection from the axillary pits 8 to 39 lymph nodes were taken out, an average of 13.81+5.56. Metastases have been found in 1 to 23 lymph nodes, an average 3.14+4.71. In 59% of the patients there have been found metastases in the axillary lymph nodes. The univariate regression analysis showed that the location, size of tumor, differentiation of the tumor, stage, the value of the Ki67 and presence of lymphovascular invasion influence on the positivity of the axillary lymph nodes. The presence of the estrogen receptors, progesterone receptors and HER2neu receptors showed that they do not have influence on the positivity for metastatic deposits in axillary lymph nodes. The multivariate model and the logistic regression analysis as independent significant factors or predictors of positivity of the axillary lymph nodes are influenced by the tumor size and the positive lymphovascular invasion.
Our study showed that the involving of the axillary lymph nodes is mainly influenced by the size of the tumor and the presence of lymphovascular invasion in the tumor. Ki67 determined proliferative index in the univariate analysis points the important influence of positivity in the axillary lymph nodes, but not in the multivariate regressive analysis.
本研究旨在确定T分期、雌激素、孕激素、HER2neu受体的存在以及Ki67值对原发性乳腺癌腋窝淋巴结转移阳性率的影响。
本研究纳入了290例接受手术治疗的乳腺癌患者。所有病例均通过标准组织学分析进行分析，包括对标准苏木精和伊红（H&E）染色的显微镜分析。为了确定分子受体——HER2neu、雌激素受体（ER）、孕激素受体（PR）、p53和Ki67，采用PT LINK免疫过氧化物酶进行免疫染色。
患者年龄在18至90岁之间，平均年龄为57.6±11.9岁。手术治疗患者的原发性肿瘤平均大小为30.27±18.3毫米。从腋窝取出8至39个淋巴结进行解剖，平均为13.81±5.56个。在1至23个淋巴结中发现转移，平均为3.14±4.71个。59%的患者腋窝淋巴结发现转移。单因素回归分析表明，肿瘤的位置、大小、分化程度、分期、Ki67值以及淋巴管侵犯对腋窝淋巴结转移阳性率有影响。雌激素受体、孕激素受体和HER2neu受体的存在表明它们对腋窝淋巴结转移灶的阳性率没有影响。多因素模型和逻辑回归分析显示，作为腋窝淋巴结转移阳性率的独立显著因素或预测指标，受肿瘤大小和淋巴管侵犯阳性的影响。
我们的研究表明，腋窝淋巴结受累主要受肿瘤大小和肿瘤中淋巴管侵犯的存在影响。单因素分析中确定增殖指数的Ki67表明其对腋窝淋巴结转移阳性率有重要影响，但在多因素回归分析中并非如此。
