乳腺肿瘤专题研究(Monographic Study of Breast Tumors)

早期乳腺癌前哨淋巴结阳性腋窝进一步处理的探讨

Published at: 2015年第24卷第11期

李涌涛 1 , 张晨光 1 , 王晓文 1 , 张明帅 1 , 欧江华 1
1 新疆医科大学附属肿瘤医院 乳腺外科,新疆 乌鲁木齐 830011
通讯作者 江华 欧 Email: oujianghua@hotmail.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.11.008
基金:
新疆医科大学创新基金资助项目 XYDCX201477

摘要

目的:探讨早期乳腺癌前哨淋巴结活检结果阳性的患者是否需要进一步腋窝淋巴结清扫。方法:回顾性分析112 例因前哨淋巴结活检阳性继续行腋窝淋巴结清扫术早期乳腺癌患者资料。结果:112 例哨淋巴结活检阳性患者中,75 例(67.0%)的腋窝淋巴结清扫后病理结果阴性。单因素分析显示,病灶大小、前哨淋巴结病理阳性个数、淋巴结外侵犯、HER-2、Ki-67、组织学分级对前哨淋巴结活检阳性继续行腋窝淋巴结病理结果有影响(均P<0.05);进一步哑变量分析显示,随着病灶大小与前哨淋巴结理阳性个数的增加,腋窝淋巴结出现阳性结果的风险明显增加(均P<0.05)。多因素分析显示,病灶大小、前哨淋巴结结果与Ki-67 表达是腋窝淋巴结清扫术结果的独立影响因素(均P<0.05)。结论:对于前哨淋巴结阳性个数1 枚、病灶≤ 2 cm 且Ki-67 低表达的早期乳腺癌患者,可建议免于行腋窝淋巴结清扫术。


Requirement analysis for further axillary treatment after positive sentinel lymph node biopsy findings in early breast cancer

Abstract

Objective: To investigate the requirement for further axillary lymph node dissection in patients with early breast cancer and positive sentinel lymph node biopsy results. Methods: The clinical data of 112 patients with early breast cancer undergoing axillary lymph node dissection due to positive sentinel lymph node biopsy results were retrospectively analyzed. Results: Of the 112 patients with positive sentinel lymph node, pathological result of lymph nodes after axillary lymph node dissection was negative in 75 cases (67.0%). Univariate analysis showed that tumor size, number of positive sentinel lymph nodes, extra lymph node invasion, HER-2, Ki-67, and histological grade had influence on pathological results of axillary lymph nodes; further dummy variable analysis demonstrated that the risk of positive axillary lymph nodes was increased with the increase of lesion size and number of positive sentinel lymph nodes. Multivariate analysis revealed that lesion size, Ki-67 expression and sentinel lymph node biopsy results were independent influential factors for results of axillary lymph node dissection (all P<0.05). Conclusion: For early breast cancer patients with a single positive sentinel lymph node, lesion ≤2 cm, and low Ki- 67 expression, avoidance of further axillary lymph node clearance may be recommended.


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引用

引用本文: 涌涛 李, 晨光 张, 晓文 王, 明帅 张, 江华 欧. 早期乳腺癌前哨淋巴结阳性腋窝进一步处理的探讨[J]. 中国普通外科杂志, 2015, 24(11): 1536-1540.
Cite this article as: LI Yongtao, ZHANG Chenguang, WANG Xiaowen, ZHANG Mingshuai, OU Jianghua . Requirement analysis for further axillary treatment after positive sentinel lymph node biopsy findings in early breast cancer[J]. Chin J Gen Surg, 2015, 24(11): 1536-1540.