Subtype is a predictive factor of nonsentinel lymph node involvement in sentinel node-positive breast cancer patients.
Subtype is a predictive factor of nonsentinel lymph node involvement in sentinel node-positive breast cancer patients.
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DOI：
10.4048/jbc.2014.17.4.370
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发表时间：
2014-12
影响因子：
2.4
通讯作者：
Kınaş V
中科院分区：
文献类型：
--
作者：
Gülben K;Berberoğlu U;Aydoğan O;Kınaş V
本研究旨在确定乳腺癌亚型对前哨淋巴结（SLN）阳性患者非前哨淋巴结（NSLN）转移的影响。回顾性评价了2009年4月至2013年9月期间104例SLN阳性的早期乳腺癌患者的记录。所有患者均行腋窝淋巴结清扫术。通过单变量和多变量统计分析，研究肿瘤亚型（管腔A型、管腔/HER 2+、人表皮生长因子受体2 [HER 2]过表达和三阴性）和其他临床病理因素对NSLN转移的影响。104例患者中有50例（48%）出现NSLN转移。单因素和多因素分析显示，肿瘤大小和阳性前哨淋巴结的比例是NSLN转移的重要危险因素。在单因素分析中，Luminal/HER 2+和HER 2过表达亚型患者的NSLN转移率高于其他亚型患者（p<0.001）。在多变量分析中，管腔/HER 2+（p<0.006）和HER 2过表达（p<0.031）亚型患者的NSLN转移风险均高于管腔A亚型患者。在评估SLN阳性患者的NSLN转移风险时，应将亚型分类作为一个独立因素。这一结果支持了包括乳腺癌亚型在内的新列线图的开发，以提高预测准确性。
This study aimed to identify the effect of breast cancer subtype on nonsentinel lymph node (NSLN) metastasis in patients with a positive sentinel lymph node (SLN). The records of 104 early breast cancer patients with a positive SLN between April 2009 and September 2013 were retrospectively evaluated. All patients underwent axillary lymph node dissection. The effects of the tumor subtype (luminal A, luminal/HER2+, human epidermal growth factor receptor 2 [HER2] overexpression, and triple-negative) and other clinicopathological factors on NSLN metastasis were examined by univariate and multivariate statistical analyses. Fifty of 104 patients (48%) exhibited NSLN metastasis. Univariate and multivariate analyses revealed that tumor size and the ratio of positive SLNs were significant risk factors of NSLN metastasis in patients with a positive SLN. The rate of NSLN metastasis was higher in patients with luminal/HER2+ and HER2 overexpression subtypes than that in patients with other subtypes in the univariate analysis (p<0.001). In the multivariate analysis, both patients with luminal/HER2+ (p<0.006) and patients with HER2 overexpression (p<0.031) subtypes had a higher risk of NSLN metastasis than patients with the luminal A subtype. Subtype classification should be considered as an independent factor when evaluating the risk of NSLN metastasis in patients with a positive SLN. This result supports the development of new nomograms including breast cancer subtype to increase predictive accuracy.
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