小肿块乳腺癌（T1a、T1b）腋窝淋巴结转移相关因素分析

发布时间：2018-03-30 13:34

本文选题：小肿块乳腺癌　切入点：腋窝淋巴结　出处：《吉林大学》2017年硕士论文

【摘要】：目的:探讨小肿块乳腺癌临床病理特征与腋窝淋巴结转移的关系,为个体化手术治疗提供理论依据。方法:回顾分析了2011年1月~2016年6月在吉林大学第一医院乳腺外科接受手术治疗的156例小肿块乳腺癌患者的临床病理资料,根据术后病理结果将其分为腋窝淋巴结阳性组和腋窝淋巴结阴性组,应用SPSS19.0软件进行统计学分析,影响腋窝淋巴结转移的临床病理指标单因素应用卡方检验分析计数资料的组间差异(必要时应用Fisher精确检验),多因素应用Logistic回归分析筛选腋窝淋巴结转移的危险因素。统计学结果以P0.05有统计学意义。结果:156例小肿块乳腺癌患者中,发生腋窝淋巴结转移23例(14.7%)。单因素分析显示在年龄、月经状况、病灶分布、乳腺X线摄影片是否存在密集点状钙化灶、T分期、病理类型、组织学分级、ER、PR、HER-2、Ki-67、分子分型中,乳腺X线摄影片是否有密集点状钙化灶及不同的T分期与腋窝淋巴结是否转移存在相关性(P0.05)。乳腺X线摄影片存在密集点状钙化的腋窝淋巴结转移发生率明显高于乳腺X线摄影片无密集点状钙化灶(28.6%vs 11.7%;P=0.023)。T1b的腋窝转移发生率明显高于T1a(18.2%vs 2.9%;P=0.024)。多因素分析显示乳腺X线摄影片是否存在密集点状钙化灶(P=0.028,OR值0.400)、T分期(P=0.027,OR值10.598)是腋窝淋巴结转移的独立危险因素。结论:乳腺X线摄影片是否存在密集点状钙化灶、T分期是影响小肿块乳腺癌发生腋窝淋巴结转移的独立危险因素。详细的术前临床病理评估能够为小肿块乳腺癌患者个体化手术治疗提供理论依据。
[Abstract]:Objective: to investigate the relationship between the clinicopathological features of small tumor breast cancer and axillary lymph node metastasis, and to provide theoretical basis for individualized surgical treatment.Methods: the clinical and pathological data of 156 patients with small mass breast cancer who received surgical treatment in the Department of Breast surgery in the first Hospital of Jilin University from January 2011 to June 2016 were retrospectively analyzed.According to the postoperative pathological results, the patients were divided into axillary lymph node positive group and axillary lymph node negative group. The results were statistically analyzed by SPSS19.0 software.The statistical results were statistically significant (P0.05).Univariate analysis showed that age, menstrual status, distribution of lesions, whether there were dense punctate calcifications in T stage, pathological type, histological grade, or not, in molecular typing.Whether there are dense punctate calcifications in mammography and whether different T stages are correlated with axillary lymph node metastasis (P0.05).The incidence of axillary lymph node metastasis in mammography with dense punctate calcification was significantly higher than that in mammography without dense punctate calcification. The incidence of axillary metastasis was significantly higher in mammography than that in T1a(18.2%vs 2.9g / T1b. The incidence of axillary metastasis was significantly higher in mammography than in mammography without dense punctate calcification.Multivariate analysis showed that the presence of dense punctate calcification in mammography or not was an independent risk factor for axillary lymph node metastasis.Conclusion: t stage is an independent risk factor for axillary lymph node metastasis in small breast cancer.Detailed preoperative clinicopathological evaluation can provide theoretical basis for individual surgical treatment of breast cancer patients with small masses.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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