| BACKGROUNDSentinel lymph node(SLN) is the first lymph node of the primary tumor, and as a barrier to prevent the spread of tumor cells from the lymph nodes, the clinical significance of sentinel lymph nodes has been paid more attention. In the gradual development of breast cancer surgery, with a large number of studies showed the same outcomes that SLNB can assess the state of axillary lymph node metastasis of early breast cancer safely and effectively, which is the clinical standard surgery if the SLN does not have metastasis. However, in a very long period of clinical practice, doctors are increasingly questioning what are the standard treatment for part of sentinel lymph node positive patients.Especially for the patients who has only 1 or 2 pieces of SLN metastases, whether there is need for further ALND, this needs further research. So explore the association between non-SLN metastasis and the related factors in breast cancer is significance for these limited patients.OBJECTIVEExplore the influencing factors related to the maeastasis of the nSLN, thus could avoid unnecessary subsequent axillary lymph node dissection and postoperative complications.METHODSBreast cancer patients of Affiliated Tumor Hospital of Guangxi Medical University Breast Surgery Department from March 2009 to June 2013 are include in the study, ALND was performed in 70 patients with sentinel lymph node metastasis.With the SPSS statistical software,we retrospectively analyze the related clinicopathological factors.RESULTS1.The univariate analysis ①Primary tumor size whether or not larger than 2cm,≤2 cm group nSLN matastasis is 33.3%, and> 2 cm group the rate is 15%,χ2=3.268, P=0.071, which is close to 0.05, no significant difference between the two groups, but there-may be differences. ②The number of positive SLN, the rate of nSLN matastasis of one positive SLN, two positive SLN and≥>3 group is 13%,43.8% and 37.5% respectively,χ2=7.411, P=0.023, there has statistically significant differences in the two groups. ③Ki-67 labeling index,< 20% group nSLN metastasis rate was 37.5%,20% or higher group nSLN transfer rate is 15.2%,χ2=4. 441, P=0.043, also has statistically significant differences.④The age, tumor location, histological grade, menopausal status, primary pathological type, the number of elimination SLN, molecular subtype, Body- mass index (BMI),all the above factors with p-value by 0.399,0.519,0.421,0.383,0.547,0.175,0.115and 0.642 respectively, have no statistically significant differences in the study.2.The multivariate analysis ①Primary tumor size turned out that is not a risk factor for nSLN matastasis by the p=0.102and OR=0.340. ②The number of SLN(+), p=0.036<0.05, The further dummy variable information shows, the p-values of the two subgroups (2 pieces SLN+ subgroup and the beyond or equal to 3 pieces SLN+subgroup) are all<0.05,by the P=0.032, OR=4.749 and p=0.041, OR=6.826 respectively. The number of SLN(+) detected independent risk factors for nSLN matastasis. ③Ki-67 labeling index P=0.036<0.05, OR=0.238<1, is not a risk factor for nSLN matastasis.CONCLUSIONThe number of positive SLN is an independent risk factor for nSLN transfer, primary tumor size and Ki-67 labeling index are not the risk factor of it,but could be related to it. And the Ki-67 labeling index, histological grade and molecular subtype have nothing to do with prediction of the nSLN metastasis. |
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