【摘要】 目的探讨前哨淋巴结浸润程度对于腋窝淋巴结转移负担及患者预后的影响。方法收集85例T1-2期且有1～2枚前哨淋巴结(SLN)转移并行腋窝淋巴结清扫的乳腺癌患者,分为ENE无外侵组、微浸润组(ENE≤2 mm)和宏浸润组(ENE> 2 mm),分析ENE程度与腋窝淋巴结转移负担及患者预后的关系。结果 ENE患者的转移淋巴结总数明显增加(P <0.05),非SLN转移数也明显高于未发生包膜外侵组(P <0.05)。在单因素生存分析中ENE≤2 mm或ENE> 2 mm患者的预后明显差于未发生外侵患者(P <0.05),但多因素分析提示转移超过3枚淋巴结与ENE> 2 mm是患者预后总生存的独立危险因素。结论 SLN发生ENE会增加淋巴结转移的负担,但不同浸润的程度会对患者的预后产生不同的影响,因此SLN的ENE程度应当被标准化。更多还原

【Abstract】 Objective To explore the effect of extracapsular nodal extension(ENE)on axillary nodal metastasis burden and survival in breast cancer patients with 1 or 2 positive sentinel lymph nodes(SLNs). Methods A total of 85 T1-2 breast cancer patients with 1 or 2 positive SLNs having undergone axillary lymph nodes dissection were divided into three groups:non-ENE,micro-ENE(≤ 2 mm)and macro-ENE(> 2 mm). Correlations of extents of ENE with axillary nodal metastasis burden and prognosis of these patients were explored. Results The total number of metastatic lymph nodes significantly elevated(P < 0.05)and the number of non-SLSs was significantly higher than that of the non-ENE group(P < 0.05). By Unadjusted Kaplan-Meier analysis the prognosis of patients with ENE ≤ 2 mm or > 2 mm was significantly poorer than that of the patients without ENE(P < 0.05,respectively). Multivariate analysis showed that nodal metastasis on more than 3 LNs and the size of ENE > 2 mm were both the independent predictors for overall survival(P < 0.05). Conclusion Presence of ENE on SLN is associated with increased nodal burden. Extranodal extension on sentinel lymph nodes to different extents renders different influences on the prognosis of patients with 1 or 2 ENE-positive SLNs. Therefore,it is needed to standardize the extent of ENE on SLNs.更多还原