發(fā)布時間：2018-07-07 08:34

  本文選題：乳腺癌 + 前哨淋巴結(jié)��； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過對前哨淋巴結(jié)(SLN)1-2枚陽性的早期乳腺癌患者的臨床資料及病理指標(biāo)進(jìn)行初步分析,分析其腋窩非前哨淋巴(NSLN)狀態(tài)及影響非前哨淋巴(NSLN)癌轉(zhuǎn)移的可能危險因素。方法:通過收集從2014年1月至2016年12月在廣西醫(yī)科大學(xué)第一附屬醫(yī)院診治的94例成功行前哨淋巴結(jié)活檢術(shù)(SLNB)病理結(jié)果診斷為前哨淋巴結(jié)(SLN)1-2枚陽性并隨即行腋窩淋巴結(jié)清掃(ALND)的早期乳腺癌患者的臨床及病理資料,采用單因素分析及多因素Logistic回歸分析方法研究各項(xiàng)臨床及病理指標(biāo)與早期乳腺癌腋窩NSLN癌轉(zhuǎn)移的關(guān)系。結(jié)果:94例SLN 1-2枚陽性的早期乳腺癌患者,根據(jù)腋窩NSLN狀態(tài)分為非前哨淋巴結(jié)陽性(NSLN+)組29例,非前哨淋巴結(jié)陰性(NSLN-)組65例,出現(xiàn)了腋窩非前哨淋巴結(jié)(NSLN)轉(zhuǎn)移約占30.8%(29/94)。將收集的資料中可能的影響因素進(jìn)行單因素差異性分析,結(jié)果顯示:ER、PR、腫瘤直徑、組織學(xué)分級、脈管癌栓、分子分型、前哨淋巴結(jié)陽性數(shù)目等因素在腋窩NSLN轉(zhuǎn)移的差異性分析均具有統(tǒng)計(jì)學(xué)意義(p0.05)。將單因素分析有統(tǒng)計(jì)學(xué)差異的因素列入多因素Logistic回歸分析,結(jié)果顯示:脈管癌栓、組織學(xué)分級、腫瘤直徑等可作為預(yù)測早期乳腺癌腋窩NSLN癌轉(zhuǎn)移的獨(dú)立危險因素。脈管癌栓(OR=13.779,95%CI 3.244~58.534)、腫瘤直徑(OR=3.663,95%CI 1.080~12.224);組織學(xué)分級(OR=3.331,95%CI1.110~10.091)。結(jié)論:本研究中,PR、ER、腫瘤直徑、組織學(xué)分級、脈管癌栓、分子分型、SLN陽性數(shù)目等與腋窩NSLN轉(zhuǎn)移有關(guān);而脈管癌栓、組織學(xué)分級、腫瘤直徑等因素可作為預(yù)測早期乳腺癌腋窩NSLN癌轉(zhuǎn)移的獨(dú)立危險因素。結(jié)果與國際上前瞻性前哨淋巴結(jié)研究結(jié)論相一致,可以作為臨床實(shí)踐參考指標(biāo)。
[Abstract]:Objective: to analyze the clinical data and pathological parameters of 1 to 2 positive sentinel lymph nodes (SLN) in patients with early breast cancer, and to analyze the status of axillary non sentinel lymph nodes (NSLN) and the risk factors affecting the metastasis of non sentinel lymph node (NSLN) carcinoma. Methods: from January 2014 to December 2016, 94 cases of sentinel lymph node biopsy (SLNB) from January 2014 to December 2016 in the first affiliated Hospital of Guangxi Medical University were collected. Clinical and pathological data of early Breast Cancer patients with Basal dissection (ALND), Univariate analysis and multivariate logistic regression analysis were used to study the relationship between clinical and pathological parameters and axillary NSLN metastasis of early breast cancer. Results 94 cases of early breast cancer with SLN 1-2 positive were divided into two groups according to the status of axillary NSLN: 29 cases in non-sentinel lymph node positive (NSLN) group and 65 cases in non-sentinel lymph node negative (NSLN-) group. The incidence of axillary non-sentinel lymph node (NSLN) metastasis was about 30.8% (29 / 94). The results of univariate analysis of the possible factors in the collected data showed that the tumor diameter, histological grade, vascular tumor embolus, molecular typing, The positive number of sentinel lymph nodes was significantly different in axillary NSLN metastasis (p0.05). Univariate analysis showed that vascular embolus, histological grade and tumor diameter could be used as independent risk factors to predict the metastasis of NSLN carcinoma in early stage of breast cancer. The diameter of the tumor was 3.66395 CI 1.08012.224, and the histological grade (OR3.33195 CI 1.1101010.091). Conclusion: in this study, PRR, tumor diameter, histological grade, vascular tumor thrombus, molecular typing and positive number of SLN were related to axillary NSLN metastasis, while vessel tumor thrombus, histological grade, and so on. Tumor diameter and other factors can be used as independent risk factors for predicting axillary NSLN metastasis of early breast cancer. Results the results are consistent with the international prospective sentinel lymph node studies and can be used as a reference index in clinical practice.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.9

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