前哨淋巴结阴性乳腺癌病人非前哨淋巴结转移相关危险因素分析
收稿日期: 2024-09-04
网络出版日期: 2025-01-23
Analysis of risk factors for non-sentinel lymph node metastasis in patients with sentinel lymph node-negative breast cancer
Received date: 2024-09-04
Online published: 2025-01-23
Supported by
Innovative research team of high-level local universities in Shanghai(SHSMU-ZDCX20212200)
目的：分析前哨淋巴结（SLN）阴性乳腺癌病人非前哨淋巴结（non-SLN, NSLN）转移的危险因素。方法：回顾性纳入2009年1月至2024年8月于我中心行全乳切除和前哨淋巴结活检的乳腺癌病人，在SLN阴性且行低位组淋巴结清扫的病人中，行NSLN转移相关危险因素单因素和多因素分析。结果：2 387例SLN阴性病人中，无NSLN转移者2 288例（95.9%），NSLN转移者99例（4.1%）。单因素及多因素分析显示：脉管侵犯(LVI)为SLN阴性病人NSLN转移的独立危险因素（13.5%比3.5%；OR=4.14，95%CI: 2.27~7.56，P<0.001）；与非多中心性乳腺癌相比，多中心性乳腺癌病人具有较高NSLN转移风险的趋势（9.5%比4.1%；OR=2.08，95% CI: 0.90~4.81，P=0.089）。结论：SLN阴性病人中，存在LVI、多中心性乳腺癌者具有较高NSLN转移风险。
张丰哲 , 童一苇 , 陈小松 , 沈坤炜 . 前哨淋巴结阴性乳腺癌病人非前哨淋巴结转移相关危险因素分析[J]. 外科理论与实践, 2024 , 29(05) : 409 -413 . DOI: 10.16139/j.1007-9610.2024.05.08
Objective To analyze the risk factors for non-sentinel lymph node (NSLN) metastasis in patients with sentinel lymph node (SLN)-negative breast cancer. Methods Patients with breast cancer who underwent mastectomy and SLN biopsy at our center between January 2009 and August 2024 were retrospectively included. Univariate and multivariate analyses were performed in SLN-negative populations underwent low axillary lymph node dissection to identify risk factors for NSLN metastasis. Results A total of 2 387 SLN-negative patients were included, including 2 288 (95.9%) without NSLN metastasis and 99 (4.1%) with NSLN metastasis. Univariate and multivariate analyses showed that lymphovascular invasion (LVI) was an independent risk factor for NSLN metastasis in SLN-negative patients (13.5% versus 3.5%; OR=4.14，95% CI: 2.27-7.56，P<0.001). Patients with multicentric breast cancer showed a trend towards higher risk of NSLN metastasis compared to other types of breast cancer (9.5% versus 4.1%; OR=2.08，95% CI： 0.90-4.81，P=0.089). Conclusions Patients with SLN-negative biopsy who have LVI or multicentric breast cancer are at higher risk for NSLN metastasis.
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