Primary breast cancer features can predict additional lymph node involvement in patients with sentinel node micrometastases
Primary breast cancer features can predict additional lymph node involvement in patients with sentinel node micrometastases
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DOI：
10.1007/s00268-005-0083-0
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发表时间：
2006-09-01
影响因子：
2.6
通讯作者：
Basaglia, E.
中科院分区：
文献类型：
--
作者：
Carcoforo, P.;Maestroni, U.;Basaglia, E.
目的：本回顾性研究的目的是确定原发性乳腺癌的生物学特征，从而预测存在进一步的腋窝受累的患者轴承微转移的前哨淋巴结（SLN）。方法：从一个起始组的690例患者中，我们孤立的SLN微转移的患者。根据非前哨淋巴结（NSLN）中是否存在进一步转移对这些患者进行分类。我们检查了原发肿瘤的特征，以确定任何相关的差异。原发性肿瘤的分析评价了组织学、肿瘤大小、淋巴血管浸润、有丝分裂指数（Mi B-1）、雌激素和孕激素受体状态（ER/PR状态）、C-er B B-2（HER-2/neu）表达和扩增以及p53表达。结果：690例患者中，296例SLN有不同程度的转移，238例SLN有大体转移。腋窝淋巴结清扫（ALND）后，102例（43%）患者有NSLN转移，136例（57%）腋窝非前哨淋巴结阴性。另外58例患者的前哨淋巴结中存在孤立性微转移。ALND后，8例（14%）患者NSLN进一步受累，50例（86%）患者腋窝淋巴结阴性。结论：分析原发性乳腺微转移性SLN和转移性NSLN患者，发现存在淋巴管浸润，Mib-1指数> 10%，肿瘤大小> 2cm。无淋巴管浸润、Mib-1 < 10%、T细胞<2cm者可避免进一步ALND。
Objective: The aim of this retrospective study was to identify biological features of primary breast cancer from which to predict the presence of further axillary involvement in patients bearing micrometastases in the sentinel lymph node (SLN).Methods: From a starting group of 690 patients, we isolated patients with micrometastases in the SLN. Those patients were classified according to the presence/absence of further metastases in nonsentinel lymph nodes (NSLNs). We examined primary tumor features to identify any relevant difference. Analysis of primary tumors evaluated histology, tumor size, lymphovascular invasion, mitotic index (Mib-1), estrogen and progesterone receptor status (ER/PR status), C-erb B-2 (HER-2/neu) expression and amplification, and p53 expression. Chi square analysis for statistical significance was applied.Results: Of the original 690 patients, 296 showed some kind of metastases in the SLN; 238 patients had gross metastases in the SLN. After axillary lymph node dissection (ALND), 102 patients (43%) had NSLNs with metastases, and 136 (57%) had negative axillary non-sentinel nodes. Another 58 patients harbored solitary micrometastases in the SLN. After ALND, 8 (14%) patients had further NSLN involvement, and 50 (86%) had negative axillary nodes.Conclusions: Analysis of the primary breast lesion in patients with micrometastatic SLN and metastatic NSLNs revealed the presence of lymphovascular invasion, Mib-1 index > 10%, and tumor size > 2 cm. Patients without lymphovascular invasion, Mib-1 < 10% and T size < 2 cm could avoid further ALND.