Clinical Significance of Extracapsular Invasion at Sentinel Lymph Nodes in Breast Cancer Patients with Sentinel Lymph Node Involvement
Clinical Significance of Extracapsular Invasion at Sentinel Lymph Nodes in Breast Cancer Patients with Sentinel Lymph Node Involvement
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前哨淋巴结受累的乳腺癌患者前哨淋巴结囊外侵犯的临床意义
DOI：
10.1245/s10434-014-4269-2
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发表时间：
2015-07-01
影响因子：
3.7
通讯作者：
Ohno, Shinji
中科院分区：
文献类型：
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作者：
Shigematsu, Hideo;Taguchi, Kenichi;Ohno, Shinji
部分患者前哨淋巴结（SLN）有囊外浸润（ECI），但仅有少数报道描述其临床意义。本研究旨在确定浸润性淋巴结转移的乳腺癌患者在淋巴结转移处行ECI的临床意义。本研究评估了2003年至2008年间在九州国立癌症中心接受腋窝淋巴结清扫的131例连续SLN阳性患者在SLN处的ECI的长期预后和非SLN转移。在131例患者中，46例（35%）在SLN检测出ECI阳性。在这46例患者中，61%（28/46）有非sln转移，而eci阴性组为28% (24/85)(chi(2)检验；P < 0.001)。多因素分析显示，SLN处的ECI可显著预测非SLN转移[危险比（HR） 3.2；95%置信区间（CI） 1.4-7.1；P = 0.005]。eci阳性组5年无复发生存率（RFS）为71.3%，eci阴性组为89.9% （P = 0.001， log-rank检验）。cox -回归分析显示，SLN的ECI独立预测较低的RFS （HR 4.5; 95% CI 1.8-11.7; P = 0.002）。研究结果表明，SLN处的ECI是累及SLN的乳腺癌患者非SLN转移和预后不良的独立预测因子。手术期乳腺癌SLN部位ECI的临床意义有待进一步研究。
A certain number of patients have extracapsular invasion (ECI) at the sentinel lymph node (SLN), but only a few reports describe its clinical significance. This study aimed to determine the clinical significance of ECI at SLN in breast cancer patients with involved SLN.This study evaluated ECI at SLN in 131 consecutive SLN-positive patients who underwent axillary lymph node dissection between 2003 and 2008 at the National Kyushu Cancer Center with regard to their long-term prognosis and non-SLN metastasis.Of the 131 patients, 46 (35 %) tested positive for ECI at SLN. Of these 46 patients, 61 % (28/46) had non-SLN metastasis compared with 28 % (24/85) in ECI-negative group (chi (2) test; P < 0.001). Multivariate analysis showed that ECI at SLN is significantly predictive for non-SLN metastasis [hazard ratio (HR) 3.2; 95 % confidence interval (CI) 1.4-7.1; P = 0.005]. The 5-year recurrence-free survival (RFS) rates were 71.3 % in the ECI-positive group and 89.9 %in the ECI-negative group (P = 0.001, log-rank test). Cox-regression analysis showed that ECI at SLN independently predicts lower RFS (HR 4.5; 95 % CI 1.8-11.7; P = 0.002).The findings show that ECI at SLN is an independent predictor of both non-SLN metastasis and poor prognosis for breast cancer patients with involved SLN. The clinical significance of ECI at SLN in operable-stage breast cancer warrants further study.