Lyu Wei, Guo Yujuan, Peng Haiyan, Xie Nanyu, Gao Hongyi
Department of Pathology, Guangdong Women and Children Hospital, Guangzhou 511400, China.
Evid Based Complement Alternat Med. 2022 Aug 9;2022:5775971. doi: 10.1155/2022/5775971. eCollection 2022.
To analyze and discuss the influencing factors of sentinel lymph node metastasis in breast cancer.
A total of 469 breast cancer patients admitted in the Department of Pathology of Guangdong Women and Children Hospital from October 2016 to December 2021 were retrospectively analyzed. The general information, immunohistochemical expression, tumor molecular subtype, tumor size, histological grade, pathological type, and tumor location were collected and the relationship with sentinel lymph node metastasis was analyzed.
For patients with different age, Ki-67 and Human epidermal growth factor receptor-2 (HER-2) immunohistochemical expression level (invasive cancer), molecular subtype (invasive cancer), tumor size, histological grade (invasive cancer) and pathological type. The results of multivariate logistic regression analysis showed that the age was less than or equal to 40 years; the molecular subtype was Luminal B and HER-2 overexpression (invasive cancer); tumor was larger; the histological grade (invasive cancer) was higher; the pathological type was invasive carcinoma, there were independent risk factors for sentinel lymph node metastasis in breast cancer. The sentinel lymph node metastasis rates of invasive lobular carcinoma, invasive micropapillary carcinoma, and metaplastic carcinoma (all met the criteria for squamous cell carcinoma and histological grade III) were higher than 50% in special invasive carcinomas.
Age, expression level of Ki 67 and HER-2, molecular typing, tumor volume and histological grade are all high-risk factors related to sentinel lymph node metastasis of breast cancer. When one or more of the above factors are involved in an examination, pathologists should be more cautious in making a sentinel lymph node frozen diagnosis. By standardizing the sampling and increasing the number of frozen sections (slicing more frozen tissue layers), the section quality can be improved. This may be conducive to reducing the false negative rate and reducing the pain and risk of secondary surgery.
分析和探讨乳腺癌前哨淋巴结转移的影响因素。
回顾性分析2016年10月至2021年12月在广东省妇幼保健院病理科收治的469例乳腺癌患者。收集其一般资料、免疫组化表达、肿瘤分子亚型、肿瘤大小、组织学分级、病理类型及肿瘤部位，并分析其与前哨淋巴结转移的关系。
不同年龄、Ki-67和人表皮生长因子受体2（HER-2）免疫组化表达水平（浸润癌）、分子亚型（浸润癌）、肿瘤大小、组织学分级（浸润癌）及病理类型的患者。多因素logistic回归分析结果显示，年龄小于或等于40岁；分子亚型为Luminal B和HER-2过表达（浸润癌）；肿瘤较大；组织学分级（浸润癌）较高；病理类型为浸润性癌，是乳腺癌前哨淋巴结转移的独立危险因素。特殊浸润性癌中，浸润性小叶癌、浸润性微乳头状癌和化生性癌（均符合鳞状细胞癌及组织学III级标准）的前哨淋巴结转移率均高于50%。
年龄、Ki-67和HER-2表达水平、分子分型、肿瘤体积及组织学分级均是与乳腺癌前哨淋巴结转移相关的高危因素。当检查涉及上述一项或多项因素时，病理科医生在进行前哨淋巴结冰冻诊断时应更加谨慎。通过规范取材并增加冰冻切片数量（多切几层冰冻组织），可提高切片质量。这可能有助于降低假阴性率，减少二次手术的痛苦和风险。
