Sentinel Lymph Node Positive Rate Predicts Non-Sentinel Lymph Node Metastasis in Breast Cancer

被引：15

作者：

Wang, Xuefei ^{[1
]}

Zhang, Guochao ^{[2
]}

Zuo, Zhichao ^{[3
]}

Zhu, Qingli ^{[4
]}

Wu, Shafei ^{[5
]}

Zhou, Yidong ^{[1
]}

Mao, Feng ^{[1
]}

Lin, Yan ^{[1
]}

Shen, Songjie ^{[1
]}

Zhang, Xiaohui ^{[1
]}

Qin, Xue ^{[6
]}

Yan, Cunli ^{[7
]}

Ma, Xiaoying ^{[8
]}

Shi, Yue ^{[9
]}

Sun, Qiang ^{[1
]}

机构：

[1] Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll & Hosp, Breast Surg Dept, 3 Dongdan, Beijing 100010, Peoples R China

[2] Chinese Acad Med Sci, Natl Clin Res Ctr, Peking Union Med Coll, Dept Thorac Surg,Natl Canc Ctr,Canc Canc Hosp, Beijing, Peoples R China

[3] Xiangtan Cent Hosp, Radiol Dept, Xiangtan, Peoples R China

[4] Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Ultrasound Med Dept, Beijing, Peoples R China

[5] Chinese Acad Med Sci, Peking Union Med Coll Hosp, Mol Pathol Res Ctr, Dept Pathol, Beijing, Peoples R China

[6] Langfang Peoples Hosp, Dept Oncol, Langfang, Hebei, Peoples R China

[7] Baoji Maternal & Child Hlth Hosp, Breast Surg Dept, Baoji, Shaanxi, Peoples R China

[8] Qinghai Prov Peoples Hosp, Breast Surg Dept, Xining, Qinghai, Peoples R China

[9] Shanxi Tradit Chinese Med Hosp, Breast Surg Dept, Taiyuan, Shanxi, Peoples R China

来源：

JOURNAL OF SURGICAL RESEARCH | 2022年 / 271卷

关键词：

Breast cancer; Axillary lymph node; Sentinel lymph node; BIOPSY; ONCOLOGY; WOMEN; TRIAL; RADIOTHERAPY; DISSECTION; MORBIDITY; DISEASE; AXILLA; AMAROS;

D O I：

10.1016/j.jss.2021.09.039

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: To investigate retrospectively an association between the number of metastatic sentinel lymph nodes (SLNs) per total number of SLNs per patient (i.e., the SLN positive rate, or SLN-PR) and non-SLN metastasis in breast cancer. Methods: A large population (n = 2250) underwent SLN dissection from January 1, 2014 to January 1, 2020; 627 (27.87%) had at least one positive SLN (SLN+). Among these, 283 underwent axillary lymph node (ALN) dissection, and formed the test group. Four external validation groups comprised 43 patients treated in 2019. SLN mappings were examined using methylene blue and indocyanine green. Lymph node ultrasound, SLN-PR, and pathological characteristics were compared between patients with and without non-SLN metastasis. An SLN-PR cutoff value was calculated using receiver operating characteristic (ROC) curves. As- sociations between clinicopathological variables and SLN-PR with non-SLN metastasis were analyzed by multivariate logistic regression model. Results: The median age was 47 years (IQR: 42-56 y). The median number of resected SLNs was 4. Patients with positive non-SLNs (126/283, 44.52%) had a median of 2 positive node. SLN-PR > 0.333 was a risk factor for non-SLN positivity (area under the ROC curve, 0.726); and carried significantly higher risk of non-SLN metastasis (P < 0.001). This was validated in the external group. Conclusions: SLN-PR > 0.333 was associated with greater risk of non-SLN metastasis. This provides a reference to non-SLN metastasis in patients with SLN metastasis, an indication for ALN dissection and choice of adjuvant treatment. (C) 2021 Published by Elsevier Inc.

引用

页码：59 / 66

页数：8

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