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目的:探讨新辅助化疗(neoadjuvant chemotherapy,NAC)对乳腺癌患者腋窝淋巴结数量的影响。方法:2010-03-02-2012-06-30临沂市人民医院乳腺外科收治82例临床Ⅱ~Ⅲ期乳腺癌患者,随机数字表法分为化疗组40例和手术组42例,化疗组以蒽环类CEF或EC方案行3~4个周期NAC,手术组直接接受乳腺癌改良根治术,比较两组患者的腋窝淋巴结数量。结果:40例经NAC的乳腺癌患者中,目标病灶完全缓解(CR)6例,部分缓解(PR)19例,病情稳定(SD)15例,无患者出现疾病进展(PD)。腋窝淋巴结清除以后,化疗组平均检出淋巴结总数为16.7枚(8~28枚),手术组为20.4枚(12~37枚);平均阳性淋巴结数化疗组为2.1枚(0~13枚),手术组为6.5枚(0~20枚),两组间差异均有统计学意义,P值均<0.001。结论:乳腺癌患者接受NAC以后,进行腋窝淋巴结清除时,不仅阳性淋巴结减少,得到的淋巴结总数也减少。
Objective: To investigate the effect of neoadjuvant chemotherapy (NAC) on the number of axillary lymph nodes in patients with breast cancer. Methods: The clinical data of 82 cases of clinical stage Ⅱ ~ Ⅲ breast cancer patients admitted to Department of Breast Surgery, Linyi People’s Hospital were divided into chemotherapy group (n = 40) and operation group (n = 42) Anthracycline CEF or EC program for 3 to 4 cycles of NAC, surgical group received direct radical mastectomy radical mastectomy, the number of axillary lymph nodes in both groups were compared. Results: Among 40 breast cancer patients with NAC, 6 were complete remission (CR), 19 were partial remission (PR) and 15 were stable (SD). No patient developed disease progression (PD). After the axillary lymph nodes were removed, the average number of lymph nodes in the chemotherapy group was 16.7 (8-28), and the surgical group was 20.4 (12-37). The mean number of positive lymph nodes was 2.1 (0-13) The operation group was 6.5 (0 ~ 20), with significant difference between the two groups (P <0.001). CONCLUSIONS: When breast cancer patients receive NAC, axillary lymph node clearance not only reduces the number of positive lymph nodes but also reduces the total number of lymph nodes.