基础医学与临床 ›› 2012, Vol. 32 ›› Issue (6): 693-696.

• 研究论文 • 上一篇    下一篇

乳腺癌前哨淋巴结数目的影响因素分析

郭春光,刘骞,解亦斌,王翔   

  1. 中国医学科学院肿瘤医院肿瘤研究所腹部外科
  • 收稿日期:2012-04-13 修回日期:2012-04-25 出版日期:2012-06-05 发布日期:2012-05-25
  • 通讯作者: 王翔 E-mail:xiangw@vip.sina.com

The analysis of factors on the number of sentinel lymph nodes in breast cancer patients

  • Received:2012-04-13 Revised:2012-04-25 Online:2012-06-05 Published:2012-05-25

摘要: 摘要:目的 分析影响乳腺癌前哨淋巴结数目的相关因素,探讨最佳的前哨淋巴结活检值。方法 回顾性分析2007年1月至2011年12月中国医学科学院肿瘤医院乳腺癌前哨淋巴结活检病例578例。采用Logistic回归模型分析前哨淋巴结数目与临床病理特征的相关性。结果 全组女性,平均年龄49.9(21~90)岁。总共获得2222枚前哨淋巴结,平均每例3.8枚(1~15)。淋巴结转移率17.8%(103/578),转移组和无转移组淋巴结数目无差异。单因素分析显示,术式、显像方法和体质指数影响前哨淋巴结数目(P<0.05)。多因素分析中,单纯乳房切除、联合显像、BMI≤30者前哨淋巴结较多(P<0.05)。前哨淋巴结限于5枚时,转移病例检出率100%。18.7%(108/578)病例不必继续送检淋巴结, 298枚淋巴结免于切除。结论 乳腺癌前哨淋巴结活检数量受到显像方法、乳腺术式和体质指数的影响,5枚前哨淋巴结可能是一个比较合适的参考标准。

关键词: 乳腺肿瘤, 前哨淋巴结活检, 淋巴结数目, 核医学

Abstract: Abstract:Objective To analysis the factors on the number of sentinel lymph nodes (SLN) in breast cancer patients and explore the appropriate cut-off value for SLNs. Methods Between January 2007 and December 2011, 578 cases of sentinel lymph node biopsy (SLNB) profiles were gathered retrospectively. The logistic regression model was used to evaluate the relationship between number of SLNs and clinical-pathological characteristics. Results The study group was consisted of 578 female patients with an average of 49.9 years in age (range 21 to 90). 2222 SLNs were resected in total by surgeon. The mean number of sentinel lymph nodes removed was 3.8 (range 1 to 15). Sentinel lymph nodes involved in metastasis were found in 17.8% of patients. There was no difference in the number of SLNs between the SLN-positive and the SLN-negative. In univariate analysis, variables associated with sentinel lymph nodes number were operation type, tracer technique and BMI (P<0.05 for all variables). In multivariate analysis, variables associated with number of sentinel lymph nodes were simple mastectomy, dual tracer technique and BMI≤30 (P<0.05). All the SLN-positive were screened out when the cut-off value was set to no more than 5 SLNs. Meanwhile, 18.7% of patients need no further lymph node dissection and 298 lymph nodes were spared. Conclusion The patients with the dual tracer technique, BMI≤30 or simple mastectomy are prone to harvest more sentinel lymph nodes. It is appropriate for surgeons to set cut-off value to 5 sentinel lymph nodes in breast cancer.

Key words: breast neoplasms, sentinel lymph node biopsy, number of sentinel lymph node, nuclear medicine