乳腺癌腋窝淋巴结阳性患者锁骨下淋巴结清扫对其预后的影响

摘要

Objective To investigate the influence of subclavian lymph node dissection on the prognosis of breast cancer patients with positive axillary lymph nodes .Methods Totally 158 breast cancer patients with positive axillary lymph nodes were divided into two groups:group A ( subclavian lymph nodes were not dissected ) and group B ( subclavian lymph nodes were dissected ) .The clinic pathological features of the two groups were compared .Kaplan-Meier method and Cox proportional hazard method were respectively used to make univariate and multivariate survival analysis for disease -free sur-vival ( DFS) .Results Univariate and multivariate survival analysis showed that tumor size , lymph nodes metastasis rate , the level of HER-2 expression and the dissection of subclavian lymph nodes were factors that influenced DFS ( all P<0.05).Conclusion Subclavian lymph node dissection in breast cancer patients with positive axillary lymph node is rec -ommended for patients whose tumor size is more than 5cm, the lymph node metastasis rate is more than 0.4 and the level of HER-2 expression is high .%目的：探讨锁骨下淋巴结清扫对乳腺癌腋窝淋巴结阳性患者预后的影响。方法将158例腋窝淋巴结阳性乳腺癌患者随机分为锁骨下淋巴结未清扫组（ A组）和锁骨下淋巴结清扫组（ B组），分别用Kaplan-Meier法和Cox风险模型对两组临床病理因素与患者无病生存（ DFS）时间的关系进行单因素和多因素生存分析。结果单因素和多因素分析均显示，患者的中位DFS时间与肿瘤大小、腋窝淋巴结阳性比率、人类表皮生长因子受体2（ HER-2）表达状态及锁骨下淋巴结是否清扫显著性相关（P均＜0．05）。结论对乳腺癌腋窝淋巴结阳性患者中原发肿瘤＞5 cm、HER-2高表达状态或腋窝淋巴结转移率＞0．4者进行锁骨下淋巴结清扫，可使其DFS明显延长。