BREAST-CANCER - PRIMARY TUMOR CHARACTERISTICS RELATED TO LYMPH-NODE INVOLVEMENT
BREAST-CANCER - PRIMARY TUMOR CHARACTERISTICS RELATED TO LYMPH-NODE INVOLVEMENT
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DOI：
10.1177/030089168106700104
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发表时间：
1981-01-01
期刊：
影响因子：
1.9
通讯作者：
CASCINELLI, N
中科院分区：
文献类型：
--
作者：
RASPONI, A;COSTA, A;CASCINELLI, N
在米兰国家癌症研究所[意大利]观察了842例可手术乳腺癌患者。在临床和术后检查中评估原发肿瘤的特征和区域淋巴结的状态。临床医生正确定义了原发灶的定性特征，他们通常高估了原发灶的最大直径。临床检查时区域淋巴结的状态不可靠：组织学检查时34.5%的临床未受累淋巴结含有转移性生长。患者年龄、原发灶最大直径、组织学类型和原发灶来源象限与区域淋巴结转移率显著相关。多因素分析表明，最后3个因素是自变量，而年龄，这是显着的本身，失去了重要性时，调整的其他3个因素中的至少一个。淋巴结包膜以外的淋巴结转移的扩展频率与受累淋巴结的数量有关：最大直径、组织学类型和起源部位与包膜外浸润的频率显著相关。在临床检查中，区域淋巴结状态的评估显然是不可靠的，原发灶的特征可能有助于预测区域淋巴结受累。受累淋巴结数量与包膜外浸润频率之间的直接相关性表明，阳性淋巴结患者的预后更多地取决于这一因素，而不是受累淋巴结的数量。
Consecutive patients (842) with operable breast cancer were observed at the National Cancer Institute of Milan [Italy]. Characteristics of the primary tumor and the status of regional lymph nodes were evaluated at clinical and postsurgical examination. Qualitative characteristics of the primary were properly defined by clinicians, who usually overestimated maximum diameter of the primary. The status of regional lymph nodes is not reliable at clinical examination: 34.5% of clinically uninvolved nodes contained metastatic growth at histologic examination. Age of patients, maximum diameter of the primary, histologic type and quadrant of origin of the primary tumor were significantly related to the frequency of regional node metastases. Multifactorial analysis showed that the last 3 factors were independent variables, while age, which is significant by itself, loses importance when adjusted by at least one of the other 3 factors. Frequency of extension of node metastases beyond the lymph node capsule was related to the number of involved nodes: maximum diameter, histologic type and site of origin are significantly related to the frequency of extracapsular invasion. The evaluation of the status of regional lymph nodes is apparently not reliable at clinical examination and characteristics of the primary may be useful in predicting regional lymph node involvement. The direct correlation between the number of involved nodes and the frequency of infiltration beyond the capsule suggests that prognosis of patients with positive nodes depends more on this factor than on the number of involved nodes.