首页|乳腺癌新辅助化疗后腋窝转移淋巴结病理完全缓解的预测因素及预后分析

乳腺癌新辅助化疗后腋窝转移淋巴结病理完全缓解的预测因素及预后分析

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目的 探讨乳腺癌新辅助化疗(neoadjuvant chemotherapy,NAC)后腋窝转移淋巴结病理完全缓解(pathological complete response,pCR)相关的临床病理因素,并对术后生存情况进行分析.方法 收集在嘉兴市中医医院、嘉兴市妇幼保健院、嘉兴市第一医院就诊的 116 例伴有腋窝淋巴结转移的乳腺癌患者,通过单因素分析患者的临床病理因素与乳腺癌NAC后腋窝转移淋巴结pCR的关系,应用二元Logistic回归分析其独立预测因素.采用Kaplan-Meier生存曲线分析腋窝转移淋巴结pCR和non-pCR的术后无病生存率和总生存率.结果 116 例患者中,有 52 例NAC后腋窝转移淋巴结达到pCR,占比44.83%.单因素分析显示,通过比较pCR和non-pCR,发现年龄、脉管浸润、乳腺原发肿瘤pCR、NAC前后Ki67 差值、NAC方案、NAC治疗效果差异有统计学意义(P<0.05).二元Logistic回归分析结果显示年龄、脉管浸润、乳腺原发肿瘤pCR是腋窝转移淋巴结pCR的独立预测因素(P<0.05).腋窝转移淋巴结pCR与non-pCR患者术后5年无病生存率(80.40%vs.54.60%)和总生存率(90.4%vs.70.10%)(P<0.05).结论 部分伴腋窝淋巴结转移的乳腺癌患者在NAC后淋巴结能够达到pCR.分析临床病理因素与NAC后腋窝转移淋巴结pCR的相关性,发现NAC后腋窝转移淋巴结pCR与年龄≤50岁、无脉管浸润、乳腺原发肿瘤pCR有关.同时发现,腋窝转移淋巴结pCR较non-pCR的患者预后更好.
Predictors and prognostic analysis of pathological complete response of axillary metastatic lymph nodes after neoadjuvant chemotherapy in breast cancer
Objective To investigate the clinicopathological factors associated with pathological complete response(pCR)of axillary metastatic lymph nodes in breast cancer patients after neoadjuvant chemotherapy(NAC),and to analyze the postoperative survival.Methods A total of 116 patients with breast cancer with axillary lymph node metastasis were collected from Jiaxing Hospital of TCM,Jiaxing Maternity and Child Health Care Hospital and The First Hospital of Jiaxing.Univariate analysis was used to analyze the relationship between clinicopathological factors and the pCR of axillary lymph node metastasis in breast cancer after NAC.Binary Logistic regression was used to analyze the independent predictors of the pCR of axillary lymph node metastasis in breast cancer after NAC.Kaplan-Meier survival curve was used to analyze the disease-free survival rate and overall survival rate of patients with and non-pCR of axillary metastatic lymph nodes.Results Among 116 patients,52 cases of axillary metastatic lymph nodes achieved pCR after NAC,accounting for 44.83%.Univariate analysis showed that age,vascular invasion,pCR of primary breast tumor,the difference of Ki67 before and after NAC,NAC regimen,and the efficacy of NAC were statistically significant between breast cancer patients with pCR and those non-pCR(P<0.05).Binary Logistic regression analysis showed that age,vascular invasion and pCR of primary breast tumor were independent predictors of pCR of axillary metastatic lymph nodes(P<0.05).The 5-year disease-free survival rate(80.40%vs.54.60%)and overall survival rate(90.4%vs.70.10%)of patients with pCR and non-pCR of axillary metastatic lymph nodes were compared.Conclusion Some breast cancer patients with axillary lymph node metastasis can reach pCR in lymph nodes after NAC.Analyzing the correlation between clinical pathological factors and pCR of axillary metastatic lymph nodes after NAC,it was found that pCR of axillary metastatic lymph nodes after NAC is related to age≤50 years old,no vascular infiltration,and primary breast tumor pCR.At the same time,it was found that patients with axillary metastatic lymph node pCR had a better prognosis than those with non-pCR.

Breast cancerNeoadjuvant chemotherapyAxillary lymph nodePathological complete response

徐琴、袁军、钱萍、袁琳娜、马祯一、张自然

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浙江中医药大学附属嘉兴中医院病理科,浙江嘉兴 314000

嘉兴市妇幼保健院病理科,浙江嘉兴 314000

嘉兴市第一医院病理科,浙江嘉兴 314000

嘉兴市妇幼保健院乳腺科,浙江嘉兴 314000

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乳腺癌 新辅助化疗 腋窝淋巴结 病理完全缓解

浙江省嘉兴市公益性研究计划项目

2022AD30091

2024

中国现代医生
中国医学科学院

中国现代医生

影响因子:1.571
ISSN:1673-9701
年,卷(期):2024.62(5)
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