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内乳淋巴结前哨活检在乳腺癌中的应用：系统评价和荟萃分析。

Should internal mammary lymph node sentinel biopsy be performed in breast cancer: a systematic review and meta-analysis.

机构信息

Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, 169 DongHu Road, Wuhan, 430071, People's Republic of China.

Department of Clinical Epidemiology, Aarhus University, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark.

出版信息

World J Surg Oncol. 2019 Aug 5;17(1):135. doi: 10.1186/s12957-019-1683-8.

DOI:10.1186/s12957-019-1683-8
PMID:31382973
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6683554/
Abstract

PURPOSE

Results from studies of internal mammary lymph node sentinel biopsy are inconsistent.

METHODS

A comprehensive literature search was conducted in MEDLINE, EMBASE, Scopus, Cochrane database, and Clinical Trials. Studies reporting the rate of internal mammary lymph node sentinel biopsy (IMN-SLNB) positivity were identified. We performed pooled proportion meta-analysis using random-effects meta-analyses. The correlation of IMN and axillary lymph node (AXN) metastasis was also investigated.

RESULTS

After application of inclusion and exclusion criteria, a total of 18 articles (total number of patients = 2427) were included. The pooled estimate for IMN-SLNB positivity rate was 15% (95% confidence interval (CI) 12-17%). Significant between-study heterogeneity was observed. Our results indicate that axillary lymph node metastasis is a strong predictor of IMN involvement (OR 6.01, 95% CI, 3.49, 10.34).

CONCLUSION

Internal mammary lymph nodes metastasis might be underestimated. Patients with positive axillary lymph nodes have a higher risk of internal lymph nodes metastasis. As a result, IMN-SLNB might be considered in these patients. Future work needs to be done to assess whether pathological confirmed IMN metastasis can affect patients' survival.

摘要

目的

内乳淋巴结前哨活检的研究结果不一致。

方法

在 MEDLINE、EMBASE、Scopus、Cochrane 数据库和临床试验中进行了全面的文献检索。确定了报告内乳淋巴结前哨活检 (IMN-SLNB) 阳性率的研究。我们使用随机效应荟萃分析进行了汇总比例荟萃分析。还研究了 IMN 与腋窝淋巴结 (AXN) 转移的相关性。

结果

应用纳入和排除标准后，共纳入 18 篇文章（总患者数=2427 例）。IMN-SLNB 阳性率的汇总估计值为 15%（95%置信区间[CI] 12-17%）。观察到研究间存在显著异质性。我们的结果表明，腋窝淋巴结转移是 IMN 受累的强预测因子（OR 6.01，95%CI，3.49，10.34）。

结论

内乳淋巴结转移可能被低估。腋窝淋巴结阳性的患者有更高的内淋巴结转移风险。因此，这些患者可能需要考虑进行 IMN-SLNB。需要进一步研究以评估病理证实的 IMN 转移是否会影响患者的生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/c8a770ea00e2/12957_2019_1683_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/0d27f86bef40/12957_2019_1683_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/e0d2ebd19cb4/12957_2019_1683_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/ea66f5bf6b55/12957_2019_1683_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/9be3bc89a58a/12957_2019_1683_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/7214c9c51bb2/12957_2019_1683_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/c8a770ea00e2/12957_2019_1683_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/0d27f86bef40/12957_2019_1683_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/e0d2ebd19cb4/12957_2019_1683_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/ea66f5bf6b55/12957_2019_1683_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/9be3bc89a58a/12957_2019_1683_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/7214c9c51bb2/12957_2019_1683_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/6683554/c8a770ea00e2/12957_2019_1683_Fig6_HTML.jpg

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