肿瘤大小、雌激素受体、孕激素受体、HER2Neu受体的持续存在及Ki67值对腋窝检查临床阴性的早期乳腺癌患者腋窝淋巴结阳性的影响
Impact of Size of the Tumour, Persistence of Estrogen Receptors, Progesterone Receptors, HER2Neu Receptors and Ki67 Values on Positivity of Axillary Lymph Nodes in Patients with Early Breast Cancer with Clinically Negative Axillary Examination.
作者信息
Kondov Borislav, Isijanovska Rosalinda, Milenkovikj Zvonko, Petrusevska Gordana, Jovanovski-Srceva Marija, Bogdanovska-Todorovska Magdalena, Kondov Goran
机构信息
University Clinic for Thoracic and Vascular Surgery, Clinical Centre "Mother Theresa", Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Institute for Epidemiology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
出版信息
Open Access Maced J Med Sci. 2017 Oct 26;5(7):825-830. doi: 10.3889/oamjms.2017.213. eCollection 2017 Dec 15.
AIM
The study aimed to identify factors that influence the positivity of axillary lymph nodes in patients with early breast cancer and clinically negative axillary lymph nodes, who were subjected for modified radical mastectomy and axillary lymphadenectomy.
MATERIAL AND METHODS
This study included 81 surgically treated, early breast cancer patients during the period from 08-2015 to 05-2017. All the cases have been analysed by standard histological analysis including macroscopic and microscopic examination by routine H&E staining. For determination of molecular receptors, immunostaining by PT LINK immunoperoxidase has been done for HER2neu, ER, PR, p53 and Ki67.
RESULTS
Patients age ranged between 31-73 years, an average of 56.86 years. The mean size of a primary tumour in the surgically treated patient was 20.33 ± 6.0 mm. Axillary dissection revealed from 5 to 32 lymph nodes, with an average of 14. Metastases have been found in 1 to 7 lymph nodes, with an average 0.7. Only 26 (32.1%) of the patients showed metastases in the axillary lymph nodes. The univariant regression analysis showed that the size of a tumour and presence of HER2neu receptors on cancer cells influence the positivity of the axillary lymph nodes. The presence of the estrogen receptors, progesterone receptors have no influence on the positivity for metastatic deposits of lymph nodes. Multivariant model and logistic regression analysis as significant independent factors or predictors of positivity of the axillary lymph nodes are influenced by the tumour size only.
CONCLUSION
Our study showed that the metastatic involvement of the axillary lymph nodes is mainly influenced by the size of a tumour and presence of HER2neu receptors in the univariant analysis. This point to the important influence of positivity of the axillary lymph nodes but, in multi-variant regressive analysis the lymph node status correlates with the tumour size only.
目的
本研究旨在确定影响早期乳腺癌且腋窝淋巴结临床阴性患者腋窝淋巴结阳性的因素,这些患者接受了改良根治性乳房切除术和腋窝淋巴结清扫术。
材料与方法
本研究纳入了2015年8月至2017年5月期间81例接受手术治疗的早期乳腺癌患者。所有病例均通过标准组织学分析进行分析,包括常规苏木精-伊红染色的大体和显微镜检查。为了确定分子受体,采用PT LINK免疫过氧化物酶免疫染色检测HER2neu、ER、PR、p53和Ki67。
结果
患者年龄在31 - 73岁之间,平均年龄为56.86岁。手术治疗患者原发肿瘤的平均大小为20.33±6.0毫米。腋窝清扫发现5至32个淋巴结,平均为14个。在1至7个淋巴结中发现转移,平均为0.7个。只有26例(32.1%)患者腋窝淋巴结出现转移。单变量回归分析显示,肿瘤大小和癌细胞上HER2neu受体的存在会影响腋窝淋巴结的阳性率。雌激素受体、孕激素受体的存在对淋巴结转移灶的阳性率没有影响。多变量模型和逻辑回归分析显示,作为腋窝淋巴结阳性的重要独立因素或预测指标,仅受肿瘤大小影响。
结论
我们的研究表明,在单变量分析中,腋窝淋巴结的转移受累主要受肿瘤大小和HER2neu受体存在的影响。这表明腋窝淋巴结阳性具有重要影响,但在多变量回归分析中,淋巴结状态仅与肿瘤大小相关。
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