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目的 :预测非前哨淋巴结 (non SLN)转移 ,以筛选出转移局限于前哨淋巴结 (SLN)的乳腺癌患者。方法 :采用99mTc SC作为示踪剂 ,对 95例乳腺癌患者行前哨淋巴结活检 ,对乳腺癌非前哨淋巴结转移进行单因素和多因素分析。结果 :95例患者中成功发现 91例患者有SLN (95 8% ) ,其中 85例患者SLN能准确反映腋窝淋巴结的病理状况 (93 4% )。临床肿块大小(P =0 0 2 8)、肿瘤分级 (P =0 0 40 )和原发灶cyclinD1蛋白 (P =0 0 17)的表达与non SLN转移显著相关。而Logistic多因素分析证实 ,临床肿块大小、肿瘤分级为独立的预测非前哨淋巴结转移的因子。结论 :可根据临床病理学特征 ,筛选出乳腺癌转移只局限于前哨淋巴结的患者 ,也存在免除腋窝淋巴结清扫的可能性
OBJECTIVE: To predict non SLN metastases to screen for breast cancer patients whose metastasis is limited to sentinel lymph node (SLN). Methods: Ninety-five patients with breast cancer underwent sentinel lymph node biopsy using 99mTc SC as a tracer to perform univariate and multivariate analysis on non-sentinel lymph node metastasis in breast cancer. RESULTS: Ninety-five patients were found to have SLN (95.8%) in 91 patients. Serum SLNs of 85 patients (93.4%) were accurately identified by axillary lymph nodes. The size of the clinical tumor (P = 0 0 28), tumor grade (P 0 0 40), and cyclin D1 protein (P 0 01 0 17) were significantly associated with non SLN metastasis. Logistic multivariate analysis confirmed that clinical tumor size and tumor grade were independent predictors of non-sentinel lymph node metastasis. CONCLUSIONS: According to the clinicopathological features, the patients with breast cancer metastasis confined to sentinel lymph node can be screened out, and the possibility of axillary lymph node dissection also exists