乳腺癌患者胸肌间淋巴结转移的影响因素及手术清扫.pdfVIP

518 中国肿瘤临床2014年第41卷第8期 Chin J Clin Oncol 2014,Vol.41,No.8 乳腺癌患者胸肌间淋巴结转移的影响因素及手术 清扫 ① ① ① ② 熊忠讯 徐发良 李 伟 李 进 分析乳腺癌患者胸肌间淋巴结（IPNs）的检出率、转移率及其影响因素，探讨胸肌间淋巴结清扫的意义和指征。 摘要 目的： 回顾性分析1673例接受乳腺癌改良根治术并且胸肌间淋巴结单独送病理检查患者的病理临床资料，记录IPNs的检出率和 方法： 转移情况，分析IPNs转移与肿瘤大小、腋窝淋巴结、临床分期、新辅助化疗、激素受体、Her-2表达以及乳腺癌分子亚型的关系。 本组病例IPNs检出率、IPNs总体转移率、腋窝淋巴结阳性者IPNs转移率分别为13.39%、4.3%和10.01%。IPNs转移率与腋 结果： 窝淋巴结转移、肿瘤TNM分期之间具有显著相关性（P0.05），但与激素受体状况、Her-2表达以及乳腺癌分子亚型之间未见相关 （P0.05）；新辅助化疗并未降低肿瘤局部偏晚患者的IPNs转移率；IPNs转移者表现为肿瘤较大、腋窝淋巴结转移多、TNM分期较 晚。结论：IPNs转移多见于肿瘤直径较大、腋窝淋巴结转移、TNM分期较晚、局部晚期以及适合新辅助化疗的乳腺癌患者，这些指 征可能意味着需要常规进行IPNs的手术清扫和单独送检。 关键词 乳腺癌 改良根治术 胸肌间淋巴结 影响因素 doi:10.3969/j.issn.1000-8179 Factors influencing the metastasis of Rotters lymph node and its surgical dissection in patients with breast cancer 1 1 1 2 Zhongxun XIONG , Faliang XU , Wei LI , Jin LI Correspondence to: Faliang XU; E-mail: FLXU88@163.COM 1 2 Treatment Center of Breast Diseases, Department of Pathology, Chongqing Cancer Institute, Chongqing 400030, China Abstract Objective: This study aims to analyze the occurrence rate, positive rate, and other related factors influencing interpec- toral lymph nodes (IPNs) in breast cancer patients. This work further aims to explore the significance and indications of the surgical dis- section of IPNs. Methods: Clinical and pathological data from 1673 breast cancer patients were retrospectively analyzed. All patients were subjected to modified radical mastectomy, and IPNs were pathologically examined. The occurrence rate and metastasis of IPNs were recorded, and the relationship between the IPN positive rate and tumor size, axillary nodes, clinical stages, neo-adjuvant ch