乳腺癌非前哨淋巴结转移的预测

目的 :预测非前哨淋巴结 (non SLN)转移 ,以筛选出转移局限于前哨淋巴结 (SLN)的乳腺癌患者。方法 :采用99mTc SC作为示踪剂 ,对 95例乳腺癌患者行前哨淋巴结活检 ,对乳腺癌非前哨淋巴结转移进行单因素和多因素分析。结果 :95例患者中成功发现 91例患者有SLN (95 8% ) ,其中 85例患者SLN能准确反映腋窝淋巴结的病理状况 (93 4% )。临床肿块大小(P =0 0 2 8)、肿瘤分级 (P =0 0 40 )和原发灶cyclinD1蛋白 (P =0 0 17)的表达与non SLN转移显著相关。而Logistic多因素分析证实 ,临床肿块大小、肿瘤分级为独立的预测非前哨淋巴结转移的因子。结论 :可根据临床病理学特征 ,筛选出乳腺癌转移只局限于前哨淋巴结的患者 ,也存在免除腋窝淋巴结清扫的可能性

Prediction of non-sentinel lymph node metastases in breast cancer

Purpose To identify a subset of breast cancer patients in whom metastatic disease is confined only to the sentinel lymph node(SLN) . Method A total of 95 breast cancer patients were administered with sentinel lymph node biopsy with 99mTc-SC, and non-SLN metastases were assessed in univariate and multivariate analysis. Result Successfully identified ninety-one out of 95 patients for SLN(95.8%). The accuracy of sentinel lymph node biopsy to predict the axillary lymph node status was 93.4%. Clinical tumor size (P=0.028), tumor grade(P=0.040) and the expression of cyclinD1 protein (P=0.017) were significantly correlated with the non-SLN metastases. Clinical tumor size and tumor grade were the independent predictive factors for non-SLN metastases by logistic regression model. Conclusion A subset of the breast cancer patients who have a low risk of non-SLN metastases may not require axillary lymph node dissection.