Wu Hao, Huang Yajing
Department of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Breast and Thyroid Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Transl Cancer Res. 2020 Dec;9(12):7450-7457. doi: 10.21037/tcr-20-2351.
Negative lymph node (NLN) count has been reported to associate with the prognosis of various cancers. This study aims to reveal the prognostic value of NLN count in breast cancer.
Clinical characteristics of patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The X-tile program was used to determine the optimal cutoffs for NLN count. Univariate and multivariate analysis were used to assess the risk factors for breast cancer-specific survival (BCSS).
The X-tile program identified that cutoff value of 2 and 10 could divide the patients into high, middle and low risk subgroups. According to multivariate analysis, patients with NLN count ≤1, over 60 years old, being black, higher tumor grade, higher T or N stage, negative hormone receptor, no radiotherapy or no chemotherapy would more likely suffer poor survival outcome. Subgroup analysis showed that NLN count could still predict survival independently.
NLN count is a potentially effective predictor of breast cancer and is a good supplement for N stage and TNM stage. Combining NLN count with other prognostic factors will be a better predictor for the survival of breast cancer patients.
据报道,阴性淋巴结(NLN)计数与多种癌症的预后相关。本研究旨在揭示NLN计数在乳腺癌中的预后价值。
从监测、流行病学和最终结果(SEER)数据库收集患者的临床特征。使用X-tile程序确定NLN计数的最佳临界值。采用单因素和多因素分析评估乳腺癌特异性生存(BCSS)的危险因素。
X-tile程序确定2和10的临界值可将患者分为高、中、低风险亚组。多因素分析显示,NLN计数≤1、年龄超过60岁、为黑人、肿瘤分级较高、T或N分期较高、激素受体阴性、未接受放疗或未接受化疗的患者生存结局较差的可能性更大。亚组分析表明,NLN计数仍可独立预测生存。
NLN计数是乳腺癌潜在的有效预测指标,是对N分期和TNM分期的良好补充。将NLN计数与其他预后因素相结合将能更好地预测乳腺癌患者的生存情况。