Analysis Of Risk Factors For Axillary Lymph Node Metastasis In Invasive Breast Cancer

Objective This study analyzed invasive axillary lymph node metastasis of breast cancer risk factors.To discuss the following questions:1.The clinical pathological data,analysis of invasive breast cancer patients: patients' age,menopausal status,tumor size,tumor location(left/right,quadrant),clinical examination can hit swollen lymph nodes,single/multiple,mammography shown in the presence of burrs,mammography shown in the presence of calcification situation,pathologic stage,the presence of vascular invasion situation,presence of nerve infiltration,immunohistochemical: ER,PR,Her-2,Ki-67 if there is a correlation with axillary lymph node metastasis.2.Analyze the risk factors of axillary lymph node metastasis,the risk of axillary lymph node metastasis model,establish the risk values,for predicting axillary lymph nodes metastasis to provide theoretical basis for invasive breast cancer.Materials and methods 1.Collect the Hong Kong university shenzhen hospital from January 2013 to November 2013,259 cases of invasive breast cancer patients undergoing surgery.According to the result of axillary lymph node pathology were divided into negative and positive groups,all patients with clinical pathological information collection.2.Using SPSS16.0 statistical software package for data analysis.The chi-square test analysis in patients with age(less than or equal to 45 / more than 45 years of age),menopausal status,and tumor size(diameter of less than 2 cm/diameter greater than 2 cm),tumor location(left/right,quadrant),clinical examination can hit swollen lymph nodes,single/multiple,molybdenum target as shown in the presence of burrs,molybdenum target as shown in the presence of calcification situation,pathologic stage,the presence of vascular invasion situation,presence of nerve infiltration,immunohistochemical: ER,PR,its ehrs-2,Ki-67 if there is a correlation with axillary lymph node metastasis;Using variable multiariable Logistic regression analysis,and establish the prediction equation of axillary lymph node metastasis.Results 1.The single factor analysis results first on line 16 variables single factor analysis of 259 cases,screening factors associated with axillary lymph node metastasis.By chi-square test,continuous Continuity correction chi square test for categorical data in single factor analysis,are P < 0.05 for the difference was statistically significant.The results suggest that these five factors are closely associated with axillary lymph node metastasis,tumor size,clinical examination respectively can touch whether the axillary lymph nodes,the molybdenum target inspection and tooltips lesions with or without calcification,pathological vascular infiltration,nerve infiltration.2.Multiple factors analysis results To get at the same time,tumor size,axillary can hit swollen lymph nodes,shown in mammography calcification and pathological vascular infiltration conditions,pathological nerve infiltration of sample of 228 cases of patient information and logistic analysis.The logistic analysis results with axillary lymph node transfer as the dependent variable.By single factor analysis with statistical significance of the five kinds of factors as independent variables,to enter logistics multi-factor regression analysis method,the results showed that a total of four factors(including tumor size X1,axillary can hit swollen lymph nodes X2 X3,nerve invasion,vascular infiltration condition X4)into the logistics regression equation.3.The establishment of logistics regression equation The results of multi-factor analysis the four factors of generation into the equation,get logistics regression prediction model for: logit(P)= 1.853 + 0.766 X1 + 1.185 X2 + 1.543 X3 + 1.543 X4.Logistics regression prediction model for fitting test,it is concluded that P = 0.581 > 0.05,so that the model is reasonable,fitting.According to the ROC curve to establish the best diagnostic cut-off point is about 0.7005,or P-0.7005 or higher,predict the risk of axillary metastatic lymph node is relatively high,P < 0.7005,predict the risk of axillary metastatic lymph node is relatively low.Conclusion 1.This study found that tumor size,clinical and pathologic examination axillary lymph nodes can touch and prompt vascular infiltration,nerve presence of infiltration in the axillary lymph node to the single factor and multiple factors analysis of existed significant difference,prompt tumors larger(more than 2 cm in diameter),the clinical and pathologic examination axillary lymph nodes can touch and prompt vascular infiltration,nerve invasion,is a risk factor for axillary lymph node metastasis.2.This model can predict the risk of axillary lymph node metastasis in a certain extent,but the accuracy of the model is still need to evaluate prospective multicenter validation.