Jiao D C, Zhu J J, Qiao J H, Wang L N, Ma Y Z, Yang Y, Lu Z D, Liu Z Z
Department of Breast Surgery, Affiliated Cancer Hospital of Zhengzhou University(Henan Cancer Hospital), Zhengzhou 450008, China.
Zhonghua Yi Xue Za Zhi. 2019 Oct 15;99(38):2989-2993. doi: 10.3760/cma.j.issn.0376-2491.2019.38.005.
To investigate the factors affecting the pathologic complete response (PCR) of the ipsilateral supraclavicular lymph node (ISLN) of breast cancer after neoadjuvant chemotherapy (NAC). A total of 178 patients with breast cancer who had primary ipsilateral supraclavicular lymph node metastasis (ISLNM), receiving NAC and subsequent ISLN dissection, were retrospectively reviewed. The single factor and multi factor analysis were carried out by the chi square test and the Logistic regression model. The enrolled patients were all female, 28 to 74 years old. The rate of PCR on the ISLN was 52.2%. Single factor analysis showed that KI67 expression level (χ(2)=7.717,0.005), breast PCR (bPCR) (χ(2)=33.564,0.001), and axillary PCR (aPCR) (χ(2)=31.750, 0.001) were associated with the ISLN PCR. Multifactor analysis showed that KI67 expression level (4.096, 95: 1.176-14.263, 0.027), bPCR (4.452, 95: 1.894-10.461, 0.001) and aPCR (5.183, 95: 1.974-13.605, 0.001) were independent predictors of ISLN PCR. The rate of PCR on the ISLN was 90.9% in the patients with KI67>30% and simultaneous breast and axilla PCR. The PCR rate of the ISLN after neoadjuvant chemotherapy is higher than that of the breast and axillary PCR. The expression level of KI67, the bPCR and the aPCR are independent predictors of the PCR on the ISLN.
探讨新辅助化疗（NAC）后影响乳腺癌同侧锁骨上淋巴结（ISLN）病理完全缓解（PCR）的因素。回顾性分析178例原发性同侧锁骨上淋巴结转移（ISLNM）且接受NAC及后续ISLN清扫术的乳腺癌患者。采用卡方检验和Logistic回归模型进行单因素和多因素分析。纳入患者均为女性，年龄28至74岁。ISLN的PCR率为52.2%。单因素分析显示，KI67表达水平（χ(2)=7.717，P=0.005）、乳腺PCR（bPCR）（χ(2)=33.564，P=0.001）和腋窝PCR（aPCR）（χ(2)=31.750，P=0.001）与ISLN的PCR相关。多因素分析显示，KI67表达水平（4.096，95%置信区间：1.176 - 14.263，P=0.027）、bPCR（4.452，95%置信区间：1.894 - 10.461，P=0.001）和aPCR（5.183，95%置信区间：1.974 - 13.605，P=0.001）是ISLN PCR的独立预测因素。KI67>30%且乳腺和腋窝同时达到PCR的患者中，ISLN的PCR率为90.9%。新辅助化疗后ISLN的PCR率高于乳腺和腋窝的PCR率。KI67表达水平、bPCR和aPCR是ISLN PCR的独立预测因素。
