Karahallı Önder, Acar Turan, Atahan Murat Kemal, Acar Nihan, Hacıyanlı Mehmet, Kamer Kemal Erdinç
General Surgery Clinic, Atatürk Training and Research Hospital, İzmir Katip Çelebi University, 172. Sokak no: 3 Daire: 3 Basın Sitesi, İzmir, Turkey.
Indian J Surg. 2017 Oct;79(5):418-422. doi: 10.1007/s12262-016-1500-3. Epub 2016 May 4.
Sentinel lymph node biopsy has become the routine procedure in axilla-negative breast cancer patients at most medical centers for axillary staging and local control in the recent years. Sentinel lymph node is the only focus in axillary lymph metastasis in a large portion of patients. In our trial, we investigated the clinical and pathological factors that affect the positive status of sentinel lymph node. We included 89 patients, who underwent sentinel lymph node biopsy (SLNB) with methylene blue and/or technetium-99 m Sulphur Colloid due to early-stage breast cancer. Five patients, in whom SLN was not detected and who underwent axillary dissection, were excluded from the trial. The patient age, location of the tumor, the type of the tumor, the T stage by the TNM staging system, the histological grade and type of the tumor, the status of multifocality, the lymphovascular invasion status of the tumor, and the ER, PR, and HER-neu2 status were recorded. The median age of the 89 patients was 52, 9 (±10) years. Fifty-seven (64 %) and 32 (36 %) of the 89 patients were detected to have positive and negative SLN, respectively. Assessing the SLNB positivity and the patient age, tumor size, tumor grade, multifocality, tumor localization, the T stage by the TNM staging, the ER/PR positivity/negativity, and the HER/neu2 and p53 status, the data revealed no statistically significant results with respect to SLN metastasis. The lymphovascular invasion status (LVI) was observed to statistically affect the SLN positivity ( < 0.016). We showed that LVI could be an important marker in predicting the SLN positivity in patients with axilla-negative early-stage breast cancer. In the future, upon introduction of new biomarkers and with relevant studies, it may be possible to predict the SLNB status of patients at an adequately high accuracy and a low risk.
近年来，前哨淋巴结活检已成为大多数医疗中心对腋窝阴性乳腺癌患者进行腋窝分期和局部控制的常规程序。在大部分患者中，前哨淋巴结是腋窝淋巴结转移的唯一病灶。在我们的试验中，我们研究了影响前哨淋巴结阳性状态的临床和病理因素。我们纳入了89例因早期乳腺癌接受亚甲蓝和/或锝-99m硫胶体前哨淋巴结活检（SLNB）的患者。5例未检测到前哨淋巴结且接受腋窝清扫术的患者被排除在试验之外。记录了患者年龄、肿瘤位置、肿瘤类型、TNM分期系统的T分期、肿瘤的组织学分级和类型、多灶性状态、肿瘤的淋巴管侵犯状态以及ER、PR和HER-neu2状态。89例患者的中位年龄为52.9（±10）岁。89例患者中，分别有57例（64%）和32例（36%）检测到前哨淋巴结阳性和阴性。评估前哨淋巴结活检阳性情况与患者年龄、肿瘤大小、肿瘤分级、多灶性、肿瘤定位、TNM分期的T分期、ER/PR阳性/阴性以及HER/neu2和p53状态，数据显示在前哨淋巴结转移方面无统计学显著结果。观察到淋巴管侵犯状态（LVI）在统计学上影响前哨淋巴结阳性（<0.016）。我们表明，LVI可能是预测腋窝阴性早期乳腺癌患者前哨淋巴结阳性的重要标志物。未来，随着新生物标志物的引入和相关研究，有可能以足够高的准确性和低风险预测患者的前哨淋巴结活检状态。
