前哨淋巴结1~2枚阳性乳腺癌患者非前哨淋巴结转移的影响因素

孟垒; 肖琪; 李钊; 何俊峰; 王媛媛; 谭金祥

doi:10.16016/j.1000-5404.201912219

您当前的位置：

首页 >

文章列表页 >

前哨淋巴结1~2枚阳性乳腺癌患者非前哨淋巴结转移的影响因素

临床医学 | 更新时间：2026-01-09

- 前哨淋巴结1~2枚阳性乳腺癌患者非前哨淋巴结转移的影响因素
- Influencing factors of non-sentinel lymph node metastasis in breast cancer patients with 1~2 positive sentinel lymph nodes
- 第三军医大学学报 2020年42卷第11期页码：1130-1135
- 作者机构：
- 作者简介：
- 基金信息：
  
  国家自然科学基金青年科学基金(81102008)
- DOI：10.16016/j.1000-5404.201912219
  中图分类号：
- 收稿：2019-12-24，
  
  纸质出版：2020-06-15
- 稿件说明：
移动端阅览
孟垒, 肖琪, 李钊, 等. 前哨淋巴结1~2枚阳性乳腺癌患者非前哨淋巴结转移的影响因素[J]. 第三军医大学学报, 2020,42(11):1130-1135.

Lei MENG, Qi XIAO, Zhao LI, et al. Influencing factors of non-sentinel lymph node metastasis in breast cancer patients with 1~2 positive sentinel lymph nodes[J]. Journal of Third Military Medical University, 2020, 42(11): 1130-1135.
孟垒, 肖琪, 李钊, 等. 前哨淋巴结1~2枚阳性乳腺癌患者非前哨淋巴结转移的影响因素[J]. 第三军医大学学报, 2020,42(11):1130-1135. DOI： 10.16016/j.1000-5404.201912219.

Lei MENG, Qi XIAO, Zhao LI, et al. Influencing factors of non-sentinel lymph node metastasis in breast cancer patients with 1~2 positive sentinel lymph nodes[J]. Journal of Third Military Medical University, 2020, 42(11): 1130-1135. DOI： 10.16016/j.1000-5404.201912219.

摘要

Abstract

Objective

To investigate the metastasis of non-sentinel lymph node (NSLN) in breast cancer patients with 1~2 positive axillary sentinel lymph nodes (SLN) and the related risk factors.

Methods

Clinicopathologic parameters of 383 breast cancer patients with 1~2 positive SLNs admitted in our hospital from 2016 to 2018 were collected and retrospectively studied. Univariate and multivariate analysis were used to explore the related predictors of NSLN metastasis.

Results

In the enrolled 383 patients

only 149 (38.9%) were observed with NSLN metastasis. Univariate analysis showed ultrasound axillary lymph node (ALN)

status (

0.001)

number of positive SLN (

=0.007)

number of negative SLN (

0.001)

number of SLN dissected (

0.001)

metastatic rate of SLN (

0.001) and lymph-vascular invasion (LVI

=0.003) were related with NSLN metastasis. Multivariate logistic regressive analysis indicated that ultrasound ALN status (

=0.001)

number of negative SLN (

=0.019)

metastatic rate of SLN (

=0.037)

LVI (

=0.039) and HER2 over-expression (

=0.026) were the independent predictive factors of NSLN metastasis.

Conclusion

Ultrasound ALN status

number of negative SLN

metastatic rate of SLN

LVI and HER2 over-expression can be used as the independent predictive factors of NSLN metastasis. Attention should be paid to the clinicopathological characteristics when decision of avoiding axillary lymph node dissection in breast cancer patients with 1~2 positive SLNs.

关键词

Keywords

references

GIULIANO A E KIRGAN D M GUENTHER J M Lymphatic mapping and sentinel lymphadenectomy for breast cancer Ann Surg 1994 220 3 391 401 10.1097/00000658-199409000-00015 GIULIANO A E, KIRGAN D M, GUENTHER J M, et al . Lymphatic mapping and sentinel lymphadenectomy for breast cancer[J ] . Ann Surg, 1994, 220(3): 391-401. DOI:10.1097/00000658-199409000-00015.

KRAG D N ANDERSON S J JULIAN T B Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial Lancet Oncol 2010 11 10 927 933 10.1016/S1470-2045(10)70207-2 KRAG D N, ANDERSON S J, JULIAN T B, et al . Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial[J ] . Lancet Oncol, 2010, 11(10): 927-933. DOI:10.1016/S1470-2045(10)70207-2.

LYMAN G H GIULIANO A E SOMERFIELD M R American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer J Clin Oncol 2005 23 30 7703 7720 10.1200/JCO.2005.08.001 LYMAN G H, GIULIANO A E, SOMERFIELD M R, et al . American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer[J ] . J Clin Oncol, 2005, 23(30): 7703-7720. DOI:10.1200/JCO.2005.08.001.

GIULIANO A E BALLMAN K V MCCALL L Effect of axillary dissection vs No axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis: the ACOSOG Z0011 (alliance) randomized clinical trial JAMA 2017 318 10 918 926 10.1001/jama.2017.11470 GIULIANO A E, BALLMAN K V, MCCALL L, et al . Effect of axillary dissection vs No axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis: the ACOSOG Z0011 (alliance) randomized clinical trial[J ] . JAMA, 2017, 318(10): 918-926. DOI:10.1001/jama.2017.11470.

GALIMBERTI V COLE B F VIALE G Axillary dissection versus no axillary dissection in patients with breast cancer and sentinel-node micrometastases (IBCSG 23-01): 10-year follow-up of a randomised, controlled phase 3 trial Lancet Oncol 2018 19 10 1385 1393 10.1016/S1470-2045(18)30380-2 GALIMBERTI V, COLE B F, VIALE G, et al . Axillary dissection versus no axillary dissection in patients with breast cancer and sentinel-node micrometastases (IBCSG 23-01): 10-year follow-up of a randomised, controlled phase 3 trial[J ] . Lancet Oncol, 2018, 19(10): 1385-1393. DOI:10.1016/S1470-2045(18)30380-2.

BAO X Y SUN K X TIAN X Present and changing trends in surgical modalities and neoadjuvant chemotherapy administration for female breast cancer in Beijing, China: a 10-year (2006-2015) retrospective hospitalization summary report-based study Thorac Cancer 2018 9 6 707 717 10.1111/1759-7714.12636 BAO X Y, SUN K X, TIAN X, et al . Present and changing trends in surgical modalities and neoadjuvant chemotherapy administration for female breast cancer in Beijing, China: a 10-year (2006-2015) retrospective hospitalization summary report-based study[J ] . Thorac Cancer, 2018, 9(6): 707-717. DOI:10.1111/1759-7714.12636.

刘淼王殊杨后圃 ACOSOG Z0011试验结果对中国乳腺外科医生临床实践影响的调查肿瘤防治研究 2016 43 1 48 53 10.3971/j.issn.1000-8578.2016.01.011 刘淼, 王殊, 杨后圃, 等. ACOSOG Z0011试验结果对中国乳腺外科医生临床实践影响的调查[J].肿瘤防治研究, 2016, 43(1): 48-53.DOI:10.3971/j.issn.1000-8578.2016.01.011.

LIU M WANG S YANG H P A survey of Chinese breast surgeons' response in clinical practice to ACOSOG Z0011 trial Cancer Res Prev Treat 2016 43 1 48 53 10.3971/j.issn.1000-8578.2016.01.011 LIU M, WANG S, YANG H P, et al . A survey of Chinese breast surgeons' response in clinical practice to ACOSOG Z0011 trial[J ] . Cancer Res Prev Treat, 2016, 43(1): 48-53. DOI:10.3971/j.issn.1000-8578.2016.01.011.

LUCCI A MCCALL L M BEITSCH P D Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011 J Clin Oncol 2007 25 24 3657 3663 10.1200/JCO.2006.07.4062 LUCCI A, MCCALL L M, BEITSCH P D, et al . Surgical complications associated with sentinel lymph node dissection (SLND) plus axill ary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011[J ] . J Clin Oncol, 2007, 25(24): 3657-3663. DOI:10.1200/JCO.2006.07.4062.

STRAVER M E MEIJNEN P TIENHOVEN G V Sentinel node identification rate and nodal involvement in the EORTC 10981-22023 AMAROS trial Ann Surg Oncol 2010 17 7 1854 1861 10.1245/s10434-010-0945-z STRAVER M E, MEIJNEN P, TIENHOVEN G V, et al . Sentinel node identification rate and nodal involvement in the EORTC 10981-22023 AMAROS trial[J ] . Ann Surg Oncol, 2010, 17 (7):1854-1861. DOI: 10.1245/s10434-010-0945-z.

AMIN M B GREENE F L EDGE S B The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging CA Cancer J Clin 2017 67 2 93 99 10.3322/caac.21388 AMIN M B, GREENE F L, EDGE S B, et al . The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging[J ] . CA Cancer J Clin, 2017, 67(2): 93-99. DOI:10.3322/caac.21388.

MERCADO C L BI-RADS update Radiol Clin North Am 2014 52 3 481 487 10.1016/j.rcl.2014.02.008 MERCADO C L. BI-RADS update[J]. Radiol Clin North Am, 2014, 52(3): 481-487. DOI: 10.1016/j.rcl.2014.02.008.

HIEKEN T J TRULL B C BOUGHEY J C Preoperative axillary imaging with percutaneous lymph node biopsy is valuable in the contemporary management of patients with breast cancer Surgery 2013 154 4 831 838 10.1016/j.surg.2013.07.017 HIEKEN T J, TRULL B C, BOUGHEY J C, et al . Preoperative axillary imaging with percutaneous lymph node biopsy is valuable in the contemporary management of patients with breast cancer[J ] . Surgery, 2013, 154(4): 831-838; discussion 838-840. DOI:10.1016/j.surg.2013.07.017.

GOLDHIRSCH A WINER E P COATES A S Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2013 Ann Oncol 2013 24 9 2206 2223 10.1093/annonc/mdt303 GOLDHIRSCH A, WINER E P, COATES A S, et al . Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2013[J ] . Ann Oncol, 2013, 24(9): 2206-2223. DOI:10.1093/annonc/mdt303.

RIBA M B DONOVAN K A ANDERSEN B Distress management, version 3.2019, NCCN clinical practice guidelines in oncology J Natl Compr Canc Netw 2019 17 10 1229 1249 10.6004/jnccn.2019.0048 RIBA M B, DONOVAN K A, ANDERSEN B, et al . Distress management, version 3.2019, NCCN clinical practice guidelines in oncology[J ] . J Natl Compr Canc Netw, 2019, 17(10): 1229-1249. DOI:10.6004/jnccn.2019.0048.

黄佳慧陈小松黄欧前哨淋巴结1~2枚转移乳腺癌病人非前哨淋巴结转移的预测外科理论与实践 2017 22 5 417 422 10.16139/j.1007-9610.2017.05.012 黄佳慧, 陈小松, 黄欧, 等.前哨淋巴结1~2枚转移乳腺癌病人非前哨淋巴结转移的预测[J].外科理论与实践, 2017, 22(5): 417-422.DOI:10.16139/j.1007-9610.2017.05.012.

HUANG J H CHEN X S HUANG O Predictive factors of non-sentinel lymph node metastasis in one to two positive sentinel lymph nodes in breast cancer patients J Surg Concepts Pract 2017 22 5 417 422 10.16139/j.1007-9610.2017.05.012 HUANG J H, CHEN X S, HUANG O, et al . Predictive factors of non-sentinel lymph node metastasis in one to two positive sentinel lymph nodes in breast cancer patients[J ] . J Surg Concepts Pract, 2017, 22(5): 417-422. DOI:10.16139/j.1007-9610.2017.05.012.

DINGEMANS S A DE ROOIJ P D VAN DER VUURST DE VRIES R M Validation of six nomograms for predicting non-sentinel lymph node metastases in a Dutch breast cancer population Ann Surg Oncol 2016 23 2 477 481 10.1245/s10434-015-4858-8 DINGEMANS S A, DE ROOIJ P D, VAN DER VUURST DE VRIES R M, et al . Validation of six nomograms for predicting non-sentinel lymph node metastases in a Dutch breast cancer population[J ] . Ann Surg Oncol, 2016, 23(2): 477-481. DOI:10.1245/s10434-015-4858-8.

HOUVENAEGHEL G BANNIER M NOS C Non sentinel node involvement prediction for sentinel node micrometastases in breast cancer: nomogram validation and comparison with other models Breast 2012 21 2 204 209 10.1016/j.breast.2011.09.013 HOUVENAEGHEL G, BANNIER M, NOS C, et al . Non sentinel node involvement prediction for sentinel node micrometastases in breast cancer: nomogram validation and comparison with other models[J ] . Breast, 2012, 21(2): 204-209. DOI:10.1016/j.breast.2011.09.013.

MAIMAITIAILI A WU D LIU Z Y Erratum to Analysis of factors related to non-sentinel lymph node metastasis in 296 sentinel lymph node-positive Chinese breast cancer patients Cancer Biol Med 2018 15 4 478 10.20892/j.issn.2095-3941.2018.0438 MAIMAITIAILI A, WU D, LIU Z Y, et al . Erratum to Analysis of factors related to non-sentinel lymph node metastasis in 296 sentinel lymph node-positive Chinese breast cancer patients[J ] . Cancer Biol Med, 2018, 15(4): 478. DOI:10.20892/j.issn.2095-3941.2018.0438.

MERETOJA T J STRIEN L HEIKKILÄ P S A simple nomogram to evaluate the risk of nonsentinel node metastases in breast cancer patients with minimal sentinel node involvement Ann Surg Oncol 2012 19 2 567 576 10.1245/s10434-011-1882-1 MERETOJA T J, STRIEN L, HEIKKILÄ P S, et al . A simple nomogram to evaluate the risk of nonsentinel node metastases in breast cancer patients with minimal sentinel node involvement[J ] . Ann Surg Oncol, 2012, 19(2): 567-576. DOI:10.1245/s10434-011-1882-1.

VAN ZEE K J MANASSEH D M BEVILACQUA J L A nomogram for predicting the likelihood of additional nodal metastases in breast cancer patients with a positive sentinel node biopsy Ann Surg Oncol 2003 10 10 1140 1151 10.1245/aso.2003.03.015 VAN ZEE K J, MANASSEH D M, BEVILACQUA J L, et al . A nomogram for predicting the likelihood of additional nodal metastases in breast cancer patients with a positive sentinel node biopsy[J ] . Ann Surg Oncol, 2003, 10(10): 1140-1151. DOI:10.1245/aso.2003.03.015.

CHEN J Y CHEN J J XUE J Y Predicting non-sentinel lymph node metastasis in a Chinese breast cancer population with 1-2 positive sentinel nodes: development and assessment of a new predictive nomogram World J Surg 2015 39 12 2919 2927 10.1007/s00268-015-3189-z CHEN J Y, CHEN J J, XUE J Y, et al . Predicting non-sentinel lymph node metastasis in a Chinese breast cancer population with 1-2 positive sentinel nodes: development and assessment of a new predictive nomogram [J ] . World J Surg, 2015, 39(12): 2919-2927. DOI:10.1007/s00268-015-3189-z.

NOWIKIEWICZ T WNUK P MAŁKOWSKI B Application of artificial neural networks for predicting presence of non-sentinel lymph node metastases in breast cancer patients with positive sentinel lymph node biopsies Arch Med Sci 2017 13 6 1399 1407 10.5114/aoms.2016.57677 NOWIKIEWICZ T, WNUK P, MAŁKOWSKI B, et al . Application of artificial neural networks for predicting presence of non-sentinel lymph node metastases in breast cancer patients with positive sentinel lymph node biopsies[J ] . Arch Med Sci, 2017, 13(6): 1399-1407. DOI:10.5114/aoms.2016.57677.

王娜娜王雪陈丽璇分子分型与前哨淋巴结阳性乳腺癌患者非前哨淋巴结转移的相关性分析天津医科大学学报 2018 24 5 437 441 http://d.old.wanfangdata.com.cn/Periodical/tianjykdxxb201805015 王娜娜, 王雪, 陈丽璇, 等.分子分型与前哨淋巴结阳性乳腺癌患者非前哨淋巴结转移的相关性分析[J].天津医科大学学报, 2018, 24(5): 437-441.

WANG N N WANG X CHEN L X Correlation analysis between molecular subtype and non-sentinel lymph node metastasis in breast cancer patietns with positive sentinel lymph nodes J Tianjin Med Univ 2018 24 5 437 441 http://d.old.wanfangdata.com.cn/Periodical/tianjykdxxb201805015 WANG N N, WANG X, CHEN L X, et al . Correlation analysis between molecular subtype and non-sentinel lymph node metastasis in breast cancer patietns with positive sentinel lymph nodes[J ] . J Tianjin Med Univ, 2018, 24(5): 437-441.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

基于中国人群的雌激素受体表达新分层（低/中/高）可更精准地预测HR⁺/HER2^-早期乳腺癌患者的预后

柳氮磺吡啶拮抗电离辐射对乳腺癌转移促进作用的实验研究

跨膜蛋白196对乳腺癌迁移及侵袭能力的影响

环状RNA hsa_circ_0000231与HnRNPK相互作用对乳腺癌增殖、迁移及凋亡的影响

环状RNA circACTN4促进乳腺癌细胞增殖、侵袭和转移的研究