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目的:分析腋窝淋巴结阴性乳腺癌的临床病理特征及预后的影响因素。方法:收集215例腋窝淋巴结阴性及225例淋巴结阳性乳腺癌患者的临床病理及预后资料,应用χ2检验进行组间比较,以logistic回归进行多因素分析。结果:单因素分析显示,两组间月经状况(P=0.04)、肿瘤大小(P<0.001)、肿瘤分级(P=0.008)、肿瘤位置(P=0.001)差异均有统计学意义。多因素分析显示,肿瘤大小和肿瘤位置是影响淋巴结阴性和阳性乳腺癌患者独立的临床病理因素。两组预后指标分析显示,阴性组有较低的复发率(P<0.001)及远处转移率(P=0.002),有较高的术后生存率(P<0.001)。其中,肿瘤大小(P<0.001)、肿瘤分级(P=0.003)、肿瘤位置(P<0.001)是影响淋巴结阴性乳腺癌患者5年无病生存的因素;肿瘤大小(P=0.012)和肿瘤位置(P<0.001)是影响淋巴结阴性乳腺癌患者5年总生存的因素。结论:淋巴结阴性乳腺癌患者有较好的预后,肿块大小、肿瘤位置是淋巴结阴性乳腺癌患者的独立临床病理因素,也是影响淋巴结阴性乳腺癌患者5年无病生存率及总生存率的预后指标。
Objective: To analyze the clinicopathological features and prognosis of axillary lymph node-negative breast cancer. Methods: The clinical data of 215 patients with axillary lymph node negative and 225 patients with lymph node positive breast cancer were collected. Chi-square test was used to compare the two groups. Multivariate analysis was performed by logistic regression. Results: Univariate analysis showed that there were significant differences in menstrual status (P = 0.04), tumor size (P <0.001), tumor grade (P = 0.008) and tumor location (P = 0.001) between the two groups. Multivariate analysis showed that tumor size and tumor location were independent clinicopathological factors influencing lymph node-negative and positive breast cancer patients. The prognostic indicators of the two groups showed that the negative group had a lower recurrence rate (P <0.001) and distant metastasis (P = 0.002), and a higher postoperative survival rate (P <0.001). Among them, tumor size (P <0.001), tumor grade (P = 0.003) and tumor location (P <0.001) were the factors affecting 5-year disease-free survival in patients with node-negative breast cancer; tumor size (P <0.001) were the factors influencing 5-year overall survival in patients with node-negative breast cancer. Conclusion: The patients with lymph node-negative breast cancer have better prognosis, tumor size and tumor location are independent clinicopathological factors in patients with node-negative breast cancer, and are prognostic indicators of 5-year disease-free survival rate and overall survival rate in patients with node-negative breast cancer .