【摘要】 目的分析乳腺导管内癌(ductal carcinoma in situ DCIS)伴前哨淋巴结转移的临床病理特征,探讨影响DCIS伴前哨淋巴结转移的高危因素。方法回顾性分析2007年1—2017年1月收治的379例DCIS行前哨淋巴结活检的患者资料,其中前哨淋巴结转移患者共70例,前哨淋巴结未转移309例;应用χ~2检验、Logistic(逐步法)回归分析等统计学方法分析临床病理特征与前哨淋巴结转移的关系。结果 18.5%(70/379) DCIS患者发生了前哨淋巴结转移。单因素分析显示,前哨淋巴结转移与原发肿瘤大小、患者年龄、组织学分级、ER和PR状态有关(Z=-2.075,P=0.038;χ~2=8.545,P=0.003;χ~2=4.344,P=0.037;χ~2=4.216,P=0.040;χ~2=6.186,P=0.013)。多因素分析显示,原发肿瘤大小、患者年龄、组织学分级是DCIS前哨淋巴结转移的独立影响因素(OR=4.114,95%CI:1.550~10.919,P=0.005; OR=2.454,95%CI:1.027~5.867,P=0.043; OR=0.370,95%CI:0.165~0.832,P=0.016)。结论原发肿瘤大小、患者年龄、组织学分级与DCIS前哨淋巴结转移相关,伴随这些高危因素的DCIS患者都应该考虑行前哨淋巴结活检。更多还原

【Abstract】 Objective To analyze the clinical pathological features of ductal carcinoma in situ of breast with sentinel lymph node metastasis,and to explore the risk factors associated with sentinel lymph node metastasis in ductal carcinoma in situ of breast.Methods The clinical data of 379 patients with ductal carcinoma in situ and received sentinel lymph node biopsy in our hospital during January 2007 and January 2017 were retrospectively analyzed. Of which 70 cases complicated with sentinel lymph node metastasis,and 309 cases without sentinel lymph node metastasis. The relationship between clinical pathological features and sentinel lymph node metastasis was analyzed by chi-square test and logistic regression analysis( stepwise method).Results Sentinel lymph node metastasis occurred in 18.5%( 70/379) the 379 cases of DCSI patients. Single factor analysis showed that the occurrence of sentinel lymph node metastasis was related to primary tumor size,patient age,histological grade,and the status of the ER and PR( Z =-2.075,P = 0.038; χ~2= 8.545,P = 0.003; χ~2= 4.344,P = 0.037; χ~2= 4.216,P = 0.040; χ~2= 6.186,P = 0.013). Multivariate analysis revealed that primary tumor size,patient age,histological grade were the independent risk factors( OR = 4.114,95% CI: 1.550 ~ 10.919,P = 0.005; OR = 2.454,95% CI: 1.027 ~ 5.867,P = 0. 043; OR = 0. 370,95% CI: 0. 165 ~ 0. 832,P = 0. 016) for DCIS lymph node metastases.Conclusions Primary tumor size,patient age,histological grade were associated with sentinel lymph node metastasis in DCIS patients. DCIS patients with these high-risk factors should be considered for sentinel lymph node biopsy.更多还原