Correlation Analysis Of Axillary Lymph Node Metastasis And Prognosis In HR Positive Breast Cancer

Purpose Retrospective analysis of the first hospital affiliated to dalian medical university in April 2012-December 2015 HR positive breast cancer patients treated by the characteristics of the molecular classification,and further study the axillary lymph node metastasis and prognosis of HR-positive patients with different molecular subtypes of breast cancer.The situation provides a theoretical basis for guiding clinical molecular typing,individualized treatment options,and prognosis.Methods The clinical data,pathological diagnosis and treatment methods of 401 patients with HR positive breast cancer admitted to the First Affiliated Hospital of Dalian Medical University from April 01,2012 to December 31,2015 were retrospectively analyzed according to the 2018 CSCO Guidelines.Molecular typing of breast cancer,including Luminal A type 77 cases(19.2%),Luminal B type 274 cases(68.3%),Her-2 positive(HR positive)50 cases(12.5%),by comparing HR positive The clinicopathological features of breast cancer were used to judge the correlation between molecular typing and axillary lymph node metastasis.The pathological characteristics of each molecular subtype and the difference of axillary lymph node metastasis were analyzed by single factor analysis,and the ?2 test was performed.Differences were further analyzed by multivariate logistic regression analysis of independent risk factors for axillary lymph node metastasis;Kaplan-meier method was used to assess the difference in disease-free survival(DFS)of different molecular types of breast cancer by follow-up recurrence and metastasis.Sexuality,factors that are meaningful for univariate analysis,and further independent prognostic factors were obtained by multivariate Cox risk scale model for survival analysis using SPSS 22.0 software package.Perform statistical analysis on the data.Results 1.There were no significant differences in age,menstrual status,family history,p53 status,or vascular infiltration between the three groups(P>0.05),but there were differences in tumor stage,tumor size,lymph node status,histological grading,whether or not radiotherapy and chemotherapy were performed,recurrence and metastasis(P<0.05).Among them,the proportion of Luminal A type in stage I was higher(57.1%),while the proportion of stage III of Her-2 positive(HR positive)was higher(34.0%);the proportion of Luminal type A T1 was higher.Large(74.0%),and different from the other two groups;Luminal A lymph node metastasis rate was the lowest(28.6%),followed by Luminal B type(43.8%),the highest was Her-2 positive(HR)Positive)(76.0%),the three groups had significant differences;in the histological grade,Luminal A was mainly distributed in grades I and II(87.0%),while Her-2 positive(HR positive)was distributed in grade III(60%).2.In the univariate analysis of pathological features and axillary lymph node metastasis,there was no significant difference in age,menstrual status,and P53 status from axillary lymph node metastasis(P>0.05),but tumor size,histological grade,Ki-67.The values,vascular tumor thrombus and molecular typing were significantly different from axillary lymph node metastasis(P<0.05).The larger the tumor diameter,the higher the histological grade,the higher the lymph node metastasis rate of vascular thrombosis.The lower the Ki-67,the lower the axillary lymph node metastasis rate.For the molecular classification,Her-2 positive(HR positive)type breast cancer had the highest lymph node metastasis rate(76.0%),followed by Luminal B type(43.8%),and finally Luminal type A(28.6%).Further multivariate logistic regression analysis showed that histological grade and Ki-67 values were not independent risk factors for axillary lymph node metastasis(P>0.05).Tumor size,molecular typing(Her-2 positive)and vascular tumor thrombus were axillary fossa.Independent risk factors for lymph node metastasis(P<0.05).3.One patient(0.1%)died of follow-up in 401 HR-positive breast cancer patients,26(6.5%)were lost to follow-up,local recurrence: 18(4.8%),distant metastasis 63(16.8%),three There was no significant difference in local recurrence rate in the group,but Her-2 positive(HR positive)(32%)was higher in the distant metastasis than in the other two groups.In the3-year disease-free survival rate,Lumianl type A breast cancer was disease-free.Survival rate(89.6%)was higher than Luminal B type(80.6%),and the worst was HR positive and Her-2 positive breast cancer(64.0%).There was no statistical difference in age,menstrual status,and histological grade in the single factor analysis of prognosis.Molecular typing,tumor size,lymph node metastasis status,vascular tumor thrombus,and Ki-67 value were the disease-free survival rate of HR-positive breast cancer patients.There were statistical differences,and further multivariate analysis of tumor size and axillary lymph node status was an independent prognostic factor for disease-free survival in HR-positive breast cancer.Conclusions 1.The molecular distribution of three group of HR-positive breast cancer was different,Luminal B-type distribution was the highest,followed by Luminal A-type,HR-positive and Her-2-positive type accounted for the least.2.In HR-positive breast cancer,the rate of lymph node metastasis was different in each molecular type,HR-positive and Her-2-positive lymph node metastasis rate was the highest,and Luminal A lymph node metastasis rate was the lowest;3.Tumor size,molecular typing,and vascular tumor thrombus are independent risk factors for axillary lymph node metastasis in HR-positive breast cancer.4.In HR-positive breast cancer,the disease-free survival rate of each molecular type was different.Lumianl type A breast cancer had the highest disease-free survival rate,HR positive and Her-2 positive type was the lowest.5.Tumor size and axillary lymph node status were independent prognostic factors for HR-positive breast cancer disease-free survival.