Wu Liqin, Zhou Xianghua, Yang Fanfan
Pathology Department, Haining People's Hospital, Haining, China.
Haining People's Hospital.
Crit Rev Immunol. 2025;45(3):1-9. doi: 10.1615/CritRevImmunol.2025055318.
This study aims to explore the relationship between tumor size, lymph node status, and ER/PR/HER2 expression in breast cancer patients. A total of 117 breast cancer patients who underwent surgery at our hospital were selected as the research objects. All patients underwent ipsilateral axillary lymph node dissection or sentinel lymph node biopsy during surgery. Pathological data and ultrasound features of primary lesions were collected. Univariate and multivariate logistic regression analyses were performed to evaluate the relationship between tumor size, lymph node status, and ER/PR/HER2 expression, as well as to identify the risk factors for lymph node metastasis in breast cancer patients. Among the 117 patients, 48 were positive for ipsilateral axillary lymph node metastasis and 69 were negative. Univariate analysis showed no significant correlation between age, PR status, molecular subtype, and lymph node metastasis (P > 0.05). Univariate analysis showed that tumor size, pathological type, menopausal status, Ki67 expression, HER2 status, and ER status were significantly associated with lymph node metastasis (P < 0.05). Logistic regression further identified tumor size [odds ratio (OR) = 1.809, 95% confidence interval (CI): 1.075-3.428, P = 0.018), pathological type (OR = 2.947, 95% CI: 1.241-7.536, P = 0.012), Ki67 expression (OR = 15.923, 95% CI: 3.219-74.512, P = 0.001), HER2 status (OR = 2.509, 95% CI: 1.586-5.769, P = 0.015), and ER status (OR = 3.226, 95% CI: 1.408-8.277, P = 0.007) as independent risk factors for lymph node metastasis. This study reveals that lymph node metastasis in breast cancer patients is significantly associated with larger tumor size (> 20 mm), invasive tumor type, higher Ki67 expression, HER2 positivity, and ER negativity. These findings emphasize the importance of incorporating these risk factors into clinical assessments to guide individualized treatment planning. By identifying patients with elevated lymph node metastasis risk, clinicians can better tailor treatment strategies to improve patient outcomes and optimize therapeutic interventions.
本研究旨在探讨乳腺癌患者肿瘤大小、淋巴结状态与雌激素受体（ER）/孕激素受体（PR）/人表皮生长因子受体2（HER2）表达之间的关系。选取我院117例行手术治疗的乳腺癌患者作为研究对象。所有患者在手术中均进行了同侧腋窝淋巴结清扫或前哨淋巴结活检。收集原发灶的病理数据及超声特征。采用单因素和多因素logistic回归分析来评估肿瘤大小、淋巴结状态与ER/PR/HER2表达之间的关系，并确定乳腺癌患者淋巴结转移的危险因素。117例患者中，48例同侧腋窝淋巴结转移阳性，69例阴性。单因素分析显示，年龄、PR状态、分子亚型与淋巴结转移无显著相关性（P>0.05）。单因素分析显示，肿瘤大小、病理类型、绝经状态、Ki67表达、HER2状态及ER状态与淋巴结转移显著相关（P<0.05）。logistic回归进一步确定肿瘤大小[比值比（OR）=1.809，95%置信区间（CI）：1.075 - 3.428，P = 0.018]、病理类型（OR = 2.947，95%CI：1.241 - 7.536，P = 0.012）、Ki67表达（OR = 15.923，95%CI：3.219 - 74.512，P = 0.001）、HER2状态（OR = 2.509，95%CI：1.586 - 5.769，P = 0.015）及ER状态（OR = 3.226，95%CI：1.408 - 8.277，P = 0.007）为淋巴结转移的独立危险因素。本研究表明，乳腺癌患者的淋巴结转移与较大的肿瘤大小（>20mm）、浸润性肿瘤类型、较高的Ki67表达、HER2阳性及ER阴性显著相关。这些发现强调了将这些危险因素纳入临床评估以指导个体化治疗方案制定的重要性。通过识别淋巴结转移风险升高的患者，临床医生可以更好地调整治疗策略，以改善患者预后并优化治疗干预措施。
