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[目的]探讨淋巴结转移率(LNR)对腋窝淋巴结阳性乳腺癌的预后意义。[方法]2012-2016年期间经病理诊断明确腋窝淋巴结阳性且ALND清扫淋巴结数目10枚以上;术后根据诊疗规范进行术后辅助治疗。共有112例淋巴结转移乳腺癌病例作为研究对象,分析不同临床病理特征下淋巴结清扫数、淋巴结转移数和淋巴结转移率。随访截止时间为2016年10月30日,中位随访时间36个月,分析不同LNR分级病例的预后差异。[结果]112例患者中平均转移淋巴结数为4.51±5.42枚;平均淋巴结转移率为20.51%±22.38%。全组患者1年生存率为97.3%,3年生存率为92.1%。以LNR为0.25为界,LNR<0.25者84例,3年生存率为94.6%,LNR≥0.25者28例,3年生存率为84.8%,两组差异有统计学意义(P<0.05)。Cox多因素分析显示分期和LNR是独立的预后因素。[结论]LNR是淋巴结阳性乳腺癌独立的预后因素。
[Objective] To investigate the prognostic significance of lymph node metastasis (LNR) in axillary lymph node positive breast cancer. [Methods] From 2012 to 2016, the axillary lymph nodes were positive and ALND lymph node number was more than 10 in the pathological diagnosis. Postoperative adjuvant therapy was performed according to the diagnosis and treatment criteria. A total of 112 cases of breast cancer with lymph node metastases were used as research subjects. The number of lymph node dissections, lymph node metastases, and lymph node metastases under different clinicopathologic features were analyzed. The follow-up cut-off time was October 30, 2016, and the median follow-up time was 36 months. The prognosis of different LNR graded cases was analyzed. [Results] The average number of metastatic lymph nodes in 112 patients was 4.51±5.42 pieces; the average lymph node metastasis rate was 20.51%±22.38%. The 1-year survival rate of the whole group was 97.3%, and the 3-year survival rate was 92.1%. With LNR 0.25 as the limit, 84 patients with LNR <0.25, 3-year survival rate was 94.6%, 28 patients with LNR ≥ 0.25, and 3-year survival rate was 84.8%. There was a significant difference between the two groups (P < 0.05). Cox multivariate analysis showed that staging and LNR were independent prognostic factors. [Conclusion] LNR is an independent prognostic factor for lymph node positive breast cancer.