Predictors of sentinel lymph node metastasis in Chinese women with clinical T1-T2 N0 breast cancer and a normal axillary ultrasound
Predictors of sentinel lymph node metastasis in Chinese women with clinical T1-T2 N0 breast cancer and a normal axillary ultrasound
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腋窝超声检查正常的中国临床 T1-T2 N0 乳腺癌女性前哨淋巴结转移的预测因素
DOI：
10.1177/02841851211054191
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发表时间：
2021-10-30
期刊：
影响因子：
1.3
通讯作者：
Xie, Yuntao
中科院分区：
文献类型：
--
作者：
Fu, Fenfen;Zhang, Yonghui;Xie, Yuntao
背景腋窝超声（AUS）正常的临床T1-T2 N 0（cT 1-T2 N 0）患者前哨淋巴结（SLN）转移的临床病理学预测因素尚不清楚。目的探讨AUS正常的cT 1-T2 N 0患者原发肿瘤的临床病理特征与前哨淋巴结转移的关系。材料和方法纳入2016年10月至2018年9月期间在一家医院诊断为cT 1-T2 N 0浸润性乳腺癌并获得正常AUS结果的患者。收集临床病理资料，采用多因素Logistic回归模型分析SLN转移的预测因素。结果141例AUS正常者中26例（18.4%）发生前哨淋巴结转移，其中24例（17.0%）有1 ~ 2个淋巴结受累。单因素分析中，肿瘤部位、雌激素受体（ER）、孕激素受体（PR）状态和淋巴管浸润（LVI）与SLN转移显著相关（P < 0.05）。多因素分析显示肿瘤位于上外象限（比值比[OR] = 4.49，95%置信区间[CI] = 1.63-12.37; P = 0.004），阳性PR状态（OR = 13.35，95% CI = 1.60-111.39; P = 0.017）、LVI阳性（OR = 8.66，95% CI = 2.20-34.18; P = 0.002）是SLN转移的独立高危因素。回归模型的受试者工作特征曲线下面积为0.787（95% CI = 0.694-0.881; P < 0.001）。结论AUS结果正常的cT 1-T2 N 0乳腺癌患者中，肿瘤位于上外象限、PR阳性和LVI状态是SLN转移的高危因素。
Background The clinicopathological predictors of sentinel lymph node (SLN) metastasis in clinical T1-T2 N0 (cT1-T2 N0) patients with a normal axillary ultrasound (AUS) are unclear. Purpose To assess the association between clinicopathological characteristics of a primary tumor and SLN metastasis in cT1-T2 N0 patients with a normal AUS. Material and Methods Patients who were diagnosed with cT1-T2 N0 invasive breast cancer and who obtained normal AUS results between October 2016 and September 2018 in a single hospital were included. Clinicopathological data were collected to explore the predictors of SLN metastasis using a multivariate logistic regression model. Results SLN metastasis occurred in 26 patients (18.4%) among 141 AUS-normal patients, of which 24 cases (17.0%) had one or two nodal involvements. In the univariate analysis, tumor location, estrogen receptor (ER) status, progesterone receptor (PR) status, and lymphovascular invasion (LVI) were significantly associated with SLN metastasis (P < 0.05). The multivariate analysis showed that tumor location in the upper outer quadrant (odds ratio [OR] = 4.49, 95% confidence interval [CI] = 1.63–12.37; P = 0.004), positive PR status (OR = 13.35, 95% CI = 1.60–111.39; P = 0.017), and positive LVI (OR = 8.66, 95% CI = 2.20–34.18; P = 0.002) were independent high-risk factors for SLN metastasis. The area under the receiver operating characteristic curve of the regression model was 0.787 (95% CI = 0.694–0.881; P < 0.001). Conclusion Tumor location in the upper outer quadrant, positive PR, and LVI status were found to be significantly high-risk factors for SLN metastasis among cT1-T2 N0 breast cancer patients with a normal AUS result.