乳腺癌改良根治术联合胸肌间淋巴结清扫的回顾性研究

目的：探讨乳腺癌胸肌间淋巴结（IPNs）的检出比、阳性比及其临床意义。方法：541例乳腺癌改良根治术行IPNs病理检查的患者,记录其IPNs检出、转移情况,分析其与年龄、病理类型、临床分期、原发肿瘤部位、肿瘤大小、尖群淋巴结、雌孕激素受体及人类表皮生长因子受体-2表达的关系。结果：IPNs的检出比为9.00%,转移比为28.26%。IPNs转移患者肿瘤原发灶较大,临床分期较晚,肿瘤位于外上象限者最多,病理类型以浸润性导管癌最多,ER表达率低,HER-2基因高表达比较高。结论：IPNs应被重视,乳癌改良根治术中对IPNs常规清扫,可对乳腺癌患者术后进行准确的临床分期,对病情作出正确评价;术后可合理选择个体化综合治疗方案、准确判断预后。

The Retrospective Study on Meliorated Radical Operation of Breast Cancer Combined with the Dissection of Interpectoral Lymph Nodes

Objective：To investigate the detection ratio and positive ratio of interpectoral nodes（IPNs） in patients with breast cancer and its clinical significance.Methods：541 patients with breast cancer were subject to the pathological examination of the IPNs.The IPNs detection rate and positive rate were recorded,then analysed the relationship between IPNs and the age,clinical stage,pathological type,primary mass location,the size of tumor,the apical group lymphnodes,ER、PR and the level expression of HER-2 gene.Results：The detective rate of interpectoral lymph nodes was 9.00 percent,and metastatic rate was 28.26 percent.The patients with metastasis of interpectoral lymph nodes had bigger primary mass and late clinical staging,which located at the upper outer quadrant and mainly belong to invasive ductal carcinoma.ER positive rate is low and the expression of HER-2 gene is high.Conclusion：IPNs should be emphasized.In modified radical mastectomy,the conventional dissection of IPNs can help us make a correct evaluation on the state of illness and clinical stage after operation in patients with breast cancer,and reasonably select individualized treatment regimen after operation and correctly judge the prognosis.