Analysis Of Influencing Factors And Correlation Of ER Expression Levels And Axillary Lymph Node Metastasis In Breast Cancer

Background:Breast cancer is the most prevalent malignancy in women,and the intensity of estrogen receptor(ER)expression and axillary lymph node(ALN)metastasis are both important indicators of survival and prognosis in breast cancer patients.Several studies have suggested that there may be an association between ER expression levels and ALN metastasis in breast cancer,however,no uniform conclusion has been reached.Objective:To study the factors affecting ER expression levels and ALN metastasis in breast cancer and to investigate the correlation between ER expression levels and ALN metastasis in different subgroups,so as to provide a reference for clinical application.Materials and Methods:According to the exclusion and inclusion criteria,the analysis was retrospectively conducted on a total of 549 breast cancer patients who attended the Department of Breast Surgery at the Second Hospital of Bethune,Jilin University,from January 2021 to October 2022.Data related to breast cancer such as age at surgery,family history,menstrual status,number of pregnancies,number of births,tumour size,tumour location,histological grading,ER,progesterone receptor(PR),human epidermal growth factor receptor-2(HER-2),Ki-67 antigen(Ki-67)and ALN metastasis were collected from patients.Statistical methods such as chisquare test/Fisher exact probability method and binary logistic regression analysis/unordered multicategorical logistic regression analysis were used to analyze the influencing factors of ER expression intensity and ALN metastasis in breast cancer and the correlation between them.Results:1.A total of 549 patients were included in this study,including 118 cases of negative ER,38 cases of low expression of ER and 393 cases of high expression of ER.And 336 patients with negative ALN,213 patients with positive ALN.2.By univariate analysis,it was concluded that the effects of menstrual status,histological grading and the expression of PR,HER-2 and Ki-67 on ER expression levels were statistically significantly different(P < 0.05).By unordered multicategorical logistic regression analysis,it was found that the expression intensity of PR and Ki-67 were independent influences on ER expression levels in breast cancer(P < 0.05).The intensity of PR expression was positively correlated with ER,and the intensity of Ki67 expression was negatively correlated with ER.3.By univariate analysis,it was concluded that the effects of menstrual status,tumour size,tumour location and histological grading on ALN were statistically significantly different(P < 0.05).By multi-factor binary logistic regression analysis,it was found that menstrual status,tumour size and tumour location were independent influences on ALN metastasis in breast cancer(P < 0.05).Breast cancer patients who were not menopausal,had larger tumours,and whose tumours were located in the outer quadrant were more likely to develop ALN metastasis.4.When exploring the relationship between ER expression levels and ALN metastasis,it was found that ER expression levels and ALN metastasis were only correlated in the HER-2 negative and Ki-67 ≤30% subgroups(p< 0.05),otherwise the two were unrelated.Conclusion:1.Factors influencing ER expression levels are menstrual status,histological grading and the expression intensity of PR,HER-2,Ki-67.2.Factors influencing ALN metastasis are menstrual status,tumor size,tumor location and histological grading.3.At the overall level,ER expression levels did not show a significant correlation with ALN metastasis.However,in the subgroup of HER-2negative and Ki-67 ≤30%,ER expression levels and ALN positivity were positively correlated.