He Zhen, Lan Xiaowen, Tan Yuting, Lin Xiao, Wen Ge, Wang Xicheng, Huang Xiaobo, Yang Fan
Department of Oncology, The First Affiliation Hospital of Guangdong Pharmaceutical University, Guangzhou 510062, China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China.
J Oncol. 2020 Dec 29;2020:8884337. doi: 10.1155/2020/8884337. eCollection 2020.
This study aimed to identify clinicopathological factors related to the extent of axillary lymph node (ALN) involvement in early-stage BC patients with positive sentinel lymph nodes (SLNs).
This was a retrospective analysis of 566 patients in cT1-2N0M0 with 1-2 positive SLNs that underwent axillary lymph node dissection (ALND) at Sun Yat-Sen Memorial Hospital. The clinical and pathologic data from these patients were analyzed.
Of these 566 patients, 235 (41.5%) exhibited NSLN metastases. Multivariate analysis revealed that the number of positive SLNs (odds ratio (OR) = 1.511; =0.038), the ratio of metastatic/dissected SLNs (SLN metastasis rate) (OR = 2.124; < 0.001), and lymphovascular invasion (LVI) (OR = 1.503; =0.022) were all independent predictors of NSLN metastasis. Patients with 0, 1, 2, or 3 of these risk factors exhibited NSLN metastases in 29.3%, 35.7%, 50.8%, and 68.3% of cases, respectively. We additionally found that the number of positive SLNs (OR = 3.582; < 0.001), SLN metastasis rate (OR = 2.505; =0.001), LVI (OR = 2.010; =0.004), and HER2 overexpression (OR = 1.774; =0.034) were all independent predictors of N2 disease. When individuals had 0, 1, 2, 3, or 4 of these risk factors, they had four or more involved ALNs in 5.2%, 10.8%, 21.1%, 37.5%, and 70.6% of cases, respectively.
These results suggest that the number of positive SLNs, the SLN metastasis rate, and LVI are all significant predictors of ALN status in BC patients that have 1-2 positive SLNs and that have undergone ALND. In addition, HER2 overexpression was a significant predictor of N2 disease.
本研究旨在确定与前哨淋巴结（SLN）阳性的早期乳腺癌（BC）患者腋窝淋巴结（ALN）转移范围相关的临床病理因素。
这是一项对566例cT1-2N0M0且有1-2枚SLN阳性并在中山大学孙逸仙纪念医院接受腋窝淋巴结清扫术（ALND）的患者进行的回顾性分析。对这些患者的临床和病理数据进行了分析。
在这566例患者中，235例（41.5%）出现非前哨淋巴结转移。多因素分析显示，阳性SLN数量（比值比（OR）=1.511；P=0.038）、转移/清扫SLN的比例（SLN转移率）（OR=2.124；P<0.001）和淋巴管浸润（LVI）（OR=1.503；P=0.022）均为非前哨淋巴结转移的独立预测因素。具有0、1、2或3个这些危险因素的患者，非前哨淋巴结转移的病例分别占29.3%、35.7%、50.8%和68.3%。我们还发现，阳性SLN数量（OR=3.582；P<0.001）、SLN转移率（OR=2.505；P=0.001）、LVI（OR=2.010；P=0.004）和HER2过表达（OR=1.774；P=0.034）均为N2期疾病的独立预测因素。当个体具有0、1、2、3或4个这些危险因素时，其有4个或更多受累ALN的病例分别占5.2%、10.8%、21.1%、37.5%和70.6%。
这些结果表明，阳性SLN数量、SLN转移率和LVI均为有1-2枚阳性SLN且接受了ALND的BC患者ALN状态的重要预测因素。此外，HER2过表达是N2期疾病的重要预测因素。
