目的 通过分析患者前哨淋巴结（sentinel lymph node, SLN）及临床病理特征与早期乳腺癌非前哨淋巴结（non-sentinel lymph node, NSLN）转移的相关性,为腋窝淋巴结的个体化处理提供依据。方法 回顾性分析厦门医学院附属第二医院2015年3月—2018年12月98例前哨淋巴结活检（sentinel lymph node biopsy, SLNB）阳性并进一步接受腋窝淋巴结清扫（axillary lymph node dissection, ALND）的早期乳腺癌患者临床及病理资料,采用单因素分析及多因素 logistic回归分析方法,研究它们与NSLN转移的关系。结果 根据纳入和排除标准,98例患者被纳入研究,33例（33.7%）发生 NSLN 转移。单因素分析结果显示：组织学分级（P=0.021）、SLN阳性个数≥ 3（P=0.013）和脉管浸润（P <0.001）与NSLN转移相关;多因素logistic回归分析结果显示：脉管浸润是NSLN转移的独立预测因素( P = 0. 001)。结论 组织学分级、SLN 阳性个数和脉管浸润是NSLN转移的影响因素。脉管浸润是NSLN转移最重要的独立预测因素。
Objective To provide reference for the development of individualized treatment regime for axillary lymph node by analyzing sentinel lymph node (SLN) and selected clinical and pathological characteristics of that may affect non-sentinel lymph node (NSLN) metastasis during early breast cancer. Methods The clinical and pathological data of early breast cancer patients with sentinel lymph node biopsy (SLNB) positive and who further received axillary lymph node dissection (ALND) in the Second Affiliated Hospital of Xiamen Medical College from March 2015 to December 2018 were retrospectively analyzed. Univariate analysis and multiple logistic regression analysis were applied to analyze the relationships between these clinicopathological factors and NSLN metastasis. Results According to the inclusion and exclusion criteria, a total of 98 cases were enrolled in the study. Among them, 33 (33.7%) patients had NSLN metastasis. The results of univariate analysis showed that histological grade (P=0.021), ≥3 positive SLN metastasis (P=0.013), and lymph-vascular invasion (P<0.001) were associated with NSLN metastasis. The results of multiple logistic analysis revealed that lymph-vascular invasion was an independent predictor for NSLN metastasis. Conclusion Histological grade, the number of positive SLN, and lymph-vascular invasion are correlated with NSLN metastasis. Lymph-vascular invasion may be an important independent predictor for NSLN metastasis.
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