【摘要】 目的探讨前哨淋巴结(SLN)阳性的早期乳腺癌患者免行腋窝淋巴结清扫(ALND)的可行性。方法收集2014年9月—2016年9月来我院就诊的591例原发性乳腺癌患者的临床资料。根据SLN状态将患者分为SLN(-)组、SLN(+)=1组、SLN(+)=2组和SLN(+)≥3组。所有患者在行前哨淋巴结活检(SLNB)后均行ALND。比较各组腋窝淋巴结(ALN)的阳性率。结果 SLN(-)组、SLN(+)=1组、SLN(+)=2组和SLN(+)≥3组ALN阳性率分别为5.0%(16/320)、8.1%(14/172)、16.7%(12/72)和37.0%(10/27)。SLN(-)组与SLN(+)=1组的ALN阳性率差异无统计学意义(χ~2=1.926,P=0.165);SLN(+)=2组的ALN阳性率高于SLN(-)组(χ~2=12.062,P=0.001)和SLN(+)=1组(χ2=3.876,P=0.049),差异均有统计学意义;SLN(+)≥3组的ALN阳性率明显高于SLN(-)组(χ2=32.939,P<0.001)、SLN(+)=1组(χ2=15.751,P<0.001)和SLN(+)=2组(χ~2=4.714,P=0.030),差异均有统计学意义。结论 1枚SLN阳性的患者可以考虑免行ALND,而2枚及以上SLN阳性的患者则建议行ALND。更多还原

【Abstract】 Objective To explore the feasibility of omitting axillary lymph node dissection(ALND) in early breast cancer patients with positive sentinel lymph nodes(SLN).Methods Clinical data of 591 patients with primary breastcancer treated in our hospital from September 2014 to September 2016 were collected.According to the SLN status,patientswere divided into SLN(-) group(n=320),SLN(+) =1 group(n=172),SLN(+)=2 group(n=72) and SLN≥3 group(n=27).ALND was performed in all patients after sentinel lymph node biopsy(SLNB).The positive rates of axillary lymph node(ALN) were compared between groups.Results The positive rates of ALN were 5.0%(16/320),8.1%(14/172),16.7%(12/72) and 37.0%(10/27) in SLN(-) group,SLN(+) =1 group,SLN(+)=2 group and SLN≥3 group respectively.There was nosignificant difference in the positive rate of ALN between SLN(-) group and SLN(+) =1 group(χ~2=1.926,P=0.165).Thepositive rate of ALN was significantly higher in SLN(+)=2 group than that of SLN(-) group(χ~2=12.062,P=0.001) and SLN(+) =1 group(χ~2=3.876,P=0.049).The positive rate of ALN was significantly higher in the SLN(+)≥3 group than that in theSLN(-) group(χ~2=32.939,P<0.001) and SLN(+)=1 group(χ~2=15.751,P<0.001) and SLN(+) =2 group(χ2=4.714,P=0.030).Conclusion The patients with 1 SLN positive can be considered to exempt from ALND,while the patients with 2 or moreSLN positive may be recommended ALND.更多还原