Zhang L L, Ma L, Geng C Z, Jia Y, Wang X L, Liu Y P
Department of Pathology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
Zhonghua Bing Li Xue Za Zhi. 2017 Aug 8;46(8):525-529. doi: 10.3760/cma.j.issn.0529-5807.2017.08.002.
To investigate the significance of extranodal extension of axillary lymph nodes (ALN-ENE) metastases in post-operative primary invasive breast carcinoma of non-specific type. Six hundred and thirty-eight invasive breast cancer cases confirmed by postoperative pathological examination were collected from January 2006 to December 2008. The relationship of lymph node metastases and ALN-ENE with other lymph node parameters and patient outcome was analyzed. Among 638 cases, 263 (41.2%) showed axillary lymph node metastases. ALN-ENE was present in 91 cases (36.4%). The rate of ALN-ENE increased with pT stage and tumor size. Five-year recurrence-free survival rate (RFS) and 5-year overall survival rate (OS) was 86.6% and 91.2% respectively for ALN-ENE positive group, and both were lower than ALN-ENE negative group (<0.01). One hundred and forty-nine patients with 1 to 3 positive lymph nodes had a 5-year RFS of 91.9%, and 5-year OS of 92.3%, less than ALN-ENE negative group (<0.01). Univariate analysis showed ALN-ENE positively correlated with lymph node metastasis. Multivariate analysis suggested that ENE was associated with increased recurrence risk and shortened recurrence-free and overall survival, especially in patients with 1 to 3 positive lymph nodes; and it was an independent prognostic factor (<0.01). The number of lymph nodes metastases is an important predictor of survival in breast cancer patients. ALN-ENE is an independent risk indicator for recurrence and overall survival. For patients with 1 to 3 metastatic axillary lymph nodes, ALN-ENE could alter the patient's clinical pathologic staging, and therefore it is an independent prognostic factor.
探讨腋窝淋巴结结外侵犯（ALN-ENE）转移在术后非特殊类型原发性浸润性乳腺癌中的意义。收集2006年1月至2008年12月术后病理检查确诊的638例浸润性乳腺癌病例。分析淋巴结转移及ALN-ENE与其他淋巴结参数和患者预后的关系。638例患者中，263例（41.2%）出现腋窝淋巴结转移。91例（36.4%）存在ALN-ENE。ALN-ENE的发生率随pT分期和肿瘤大小增加而升高。ALN-ENE阳性组的5年无复发生存率（RFS）和5年总生存率（OS）分别为86.6%和91.2%，均低于ALN-ENE阴性组（<0.01）。149例有1至3枚阳性淋巴结的患者5年RFS为91.9%，5年OS为92.3%，低于ALN-ENE阴性组（<0.01）。单因素分析显示ALN-ENE与淋巴结转移呈正相关。多因素分析表明，ENE与复发风险增加及无复发生存期和总生存期缩短相关，尤其是在有1至3枚阳性淋巴结的患者中；且它是一个独立的预后因素（<0.01）。淋巴结转移数量是乳腺癌患者生存的重要预测指标。ALN-ENE是复发和总生存的独立风险指标。对于有1至3枚腋窝转移淋巴结的患者，ALN-ENE可改变患者的临床病理分期，因此它是一个独立的预后因素。
