前哨淋巴结1-2枚阳性的早期乳腺癌患者腋窝非前哨淋巴结转移的危险因素分析

发布时间：2018-07-07 08:34

本文选题：乳腺癌 + 前哨淋巴结　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:通过对前哨淋巴结(SLN)1-2枚阳性的早期乳腺癌患者的临床资料及病理指标进行初步分析,分析其腋窝非前哨淋巴(NSLN)状态及影响非前哨淋巴(NSLN)癌转移的可能危险因素。方法:通过收集从2014年1月至2016年12月在广西医科大学第一附属医院诊治的94例成功行前哨淋巴结活检术(SLNB)病理结果诊断为前哨淋巴结(SLN)1-2枚阳性并随即行腋窝淋巴结清扫(ALND)的早期乳腺癌患者的临床及病理资料,采用单因素分析及多因素Logistic回归分析方法研究各项临床及病理指标与早期乳腺癌腋窝NSLN癌转移的关系。结果:94例SLN 1-2枚阳性的早期乳腺癌患者,根据腋窝NSLN状态分为非前哨淋巴结阳性(NSLN+)组29例,非前哨淋巴结阴性(NSLN-)组65例,出现了腋窝非前哨淋巴结(NSLN)转移约占30.8%(29/94)。将收集的资料中可能的影响因素进行单因素差异性分析,结果显示:ER、PR、肿瘤直径、组织学分级、脉管癌栓、分子分型、前哨淋巴结阳性数目等因素在腋窝NSLN转移的差异性分析均具有统计学意义(p0.05)。将单因素分析有统计学差异的因素列入多因素Logistic回归分析,结果显示:脉管癌栓、组织学分级、肿瘤直径等可作为预测早期乳腺癌腋窝NSLN癌转移的独立危险因素。脉管癌栓(OR=13.779,95%CI 3.244~58.534)、肿瘤直径(OR=3.663,95%CI 1.080~12.224);组织学分级(OR=3.331,95%CI1.110~10.091)。结论:本研究中,PR、ER、肿瘤直径、组织学分级、脉管癌栓、分子分型、SLN阳性数目等与腋窝NSLN转移有关;而脉管癌栓、组织学分级、肿瘤直径等因素可作为预测早期乳腺癌腋窝NSLN癌转移的独立危险因素。结果与国际上前瞻性前哨淋巴结研究结论相一致,可以作为临床实践参考指标。
[Abstract]:Objective: to analyze the clinical data and pathological parameters of 1 to 2 positive sentinel lymph nodes (SLN) in patients with early breast cancer, and to analyze the status of axillary non sentinel lymph nodes (NSLN) and the risk factors affecting the metastasis of non sentinel lymph node (NSLN) carcinoma. Methods: from January 2014 to December 2016, 94 cases of sentinel lymph node biopsy (SLNB) from January 2014 to December 2016 in the first affiliated Hospital of Guangxi Medical University were collected. Clinical and pathological data of early Breast Cancer patients with Basal dissection (ALND), Univariate analysis and multivariate logistic regression analysis were used to study the relationship between clinical and pathological parameters and axillary NSLN metastasis of early breast cancer. Results 94 cases of early breast cancer with SLN 1-2 positive were divided into two groups according to the status of axillary NSLN: 29 cases in non-sentinel lymph node positive (NSLN) group and 65 cases in non-sentinel lymph node negative (NSLN-) group. The incidence of axillary non-sentinel lymph node (NSLN) metastasis was about 30.8% (29 / 94). The results of univariate analysis of the possible factors in the collected data showed that the tumor diameter, histological grade, vascular tumor embolus, molecular typing, The positive number of sentinel lymph nodes was significantly different in axillary NSLN metastasis (p0.05). Univariate analysis showed that vascular embolus, histological grade and tumor diameter could be used as independent risk factors to predict the metastasis of NSLN carcinoma in early stage of breast cancer. The diameter of the tumor was 3.66395 CI 1.08012.224, and the histological grade (OR3.33195 CI 1.1101010.091). Conclusion: in this study, PRR, tumor diameter, histological grade, vascular tumor thrombus, molecular typing and positive number of SLN were related to axillary NSLN metastasis, while vessel tumor thrombus, histological grade, and so on. Tumor diameter and other factors can be used as independent risk factors for predicting axillary NSLN metastasis of early breast cancer. Results the results are consistent with the international prospective sentinel lymph node studies and can be used as a reference index in clinical practice.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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