Great tumour burden in the axilla may influence lymphatic drainage in breast cancer patients
Great tumour burden in the axilla may influence lymphatic drainage in breast cancer patients
复制标题
腋窝的巨大肿瘤负荷可能会影响乳腺癌患者的淋巴引流
DOI：
10.1007/s10549-016-3831-y
复制
发表时间：
2016
影响因子：
3.8
通讯作者：
Wang Shui
中科院分区：
文献类型：
--
作者：
Zhou Wenbin;Zhao Yansheng;Pan Hong;Li Qin;Li Xiuqing;Chen Lin;Zha Xiaoming;Ding Qiang;Wang Cong;Liu Xiaoan;Wang Shui
我们研究了原发引流淋巴结的巨大肿瘤负荷是否会导致乳腺癌患者淋巴流受阻。从2001年1月至2011年3月，回顾性招募了具有假阴性前哨淋巴结（SLN）的乳腺癌患者。2013年12月至2014年11月，前瞻性招募了另外45名乳腺癌患者。手术前24小时，将淋巴示踪剂碳纳米颗粒注射到乳晕下区域，然后进行腋窝淋巴结清扫。在SLN队列中，在28例假阴性病例中，> 50%显示腋窝肿瘤负荷很大。在碳纳米颗粒队列中，我们发现病理累及淋巴结<3个的病例比累及淋巴结≥3个的亚组有更多的淋巴结被碳纳米颗粒染色（P= 0.003）。与未染色的淋巴结相比，碳纳米颗粒染色的淋巴结显示出更小的肿瘤负荷（P< 0.05）。此外，5例病例显示转移性淋巴结未被碳纳米颗粒染色，所有无转移的淋巴结均被碳纳米颗粒染色。腋窝肿瘤负荷过大，临床上可能导致淋巴流阻塞。尽管如此，仍需要临床试验来验证我们的发现。
We investigated whether great tumour burden in the primary draining lymph node would lead to obstructed lymphatic flow in breast cancer patients. Breast cancer patients with false-negative sentinel lymph nodes (SLNs) were enrolled from January 2001 to March 2011, retrospectively. A further 45 breast cancer patients were recruited prospectively from December 2013 to November 2014. Carbon nanoparticles, a lymphatic tracer, were injected into the subareolar area 24 h before surgery, followed by axillary lymph node dissection. In the SLN cohort, among the 28 false-negative cases, >50 % showed great tumour burden in the axilla. In the carbon nanoparticles cohort, we found that cases with <3 nodes involved in the pathology had more lymph nodes stained by carbon nanoparticles than the subgroup with ≥3 involved nodes (P= 0.003). Nodes stained with carbon nanoparticles showed smaller tumour burdens compared with unstained nodes (P< 0.05). Furthermore, five cases showed metastatic nodes that were not stained with carbon nanoparticles, and all the lymph nodes that were free of metastasis were stained with carbon nanoparticles. Great tumour burden in the axilla might lead to lymphatic flow obstructions in clinical practice. Nevertheless, clinical trials are still needed to validate our findings.