Factors predicting failure to identify a sentinel lymph node in breast cancer
Factors predicting failure to identify a sentinel lymph node in breast cancer
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DOI：
10.1016/j.surg.2005.03.003
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发表时间：
2005-07-01
期刊：
影响因子：
3.8
通讯作者：
McMasters, KM
中科院分区：
文献类型：
--
作者：
Chagpar, AB;Martin, RC;McMasters, KM
背景尽管前哨淋巴结（SLN）活检被广泛认为是一种微创的淋巴结分期方法，但如果无法识别前哨淋巴结，则需要采取。I/II级腋窝淋巴结清扫术。本研究的目的是阐明独立预测SLN识别失败的因素。通过对浸润性乳腺癌患者前哨淋巴结活检的大型多中心前瞻性研究，我们进行了单变量和多变量回归分析，以确定预测前哨淋巴结识别失败的临床病理因素。在研究的4131例患者中，249例（6.0%）未发现SLN。肿瘤位置（P =.409）、活检类型（P =.079）、手术类型（P =.380）和组织学亚型（P =.999）不是无法识别SLN的显著预测因素。多因素分析显示，年龄大于60岁（OR = 1.469，95%CI，1.116-1.934，P =. 006）、触诊阴性肿瘤（OR = 0. 006）。639; 95%CI，0.479-0.852，P =. 002）、单独使用蓝色染料的注射技术（OR = 0. 389，95% CI，0. 259-5-86，P
Background. Although sentinel lymph node (SLN) biopsy is widely accepted as a minimally invasive method of nodal staging, failure to identify an SLN mandates a. level I/II axillary node dissection. The purpose of this study was to elucidate factors that independently predict failure to identify an SLN.Methods. Using a large multicenter prospective study of SLN biopsy for patients with invasive breast cancer, we performed univariate and multivariate regression analyses to determine clinicopathologic factors predictive of failure to identify an SLN.Results. Of the total 4131 patients in the study, an SLN was not identified in 249 (6.0%). Tumor location (P =.409), biopsy type (P =.079), surgery type (P =.380), and histologic subtype (P =.999) were not significant Predictors of failure to identify an SLN. On multivariate analysis, age greater than 60 years (OR = 1.469; 95 % CI, 1.116-1.934, P =. 006), nonpalpable tumors (OR = 0. 639; 95 % CI, 0.479-0.852, P =. 002), injection technique with blue dye alone (OR = 0.389, 95 % CI, 0. 259-5-86, P