中国实用外科杂志2012，Vol.32Issue(11)：945-949,5.
乳腺癌非前哨淋巴结转移相关因素及其列线图验证性研究
Risk factors for non-sentinel lymph node metastasis and validation study of the MSKCC nomogram in patients with breast cancer
摘要
Abstract
Objective To evaluate the risk factors for non-sentinel lymph node (NSLN) metastasis, and validate the value of the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram for the prediction of NSLN metastasis in patients with breast cancer. Methods A sentinel lymph node biopsy (SLNB) database containing 1227 consecutive breast cancer patients admitted between December 2001 and January 2012 in Shandong Cancer Hospital was analyzed retrospectively. The patients with positive sentinel lymph node (SLN) should be evaluated for risk factors of NSLN metastasis. MSKCC nomogram was used to estimate probability of NSLN involvement, and the predictive accuracy was assessed by calculating the trend line and the area under the receiver-operator characteristic (ROC) curve. Results Tumor size, number of positive SLN, nuclear grade, lymphovascular invasion and multifocality correlated with NSLN metastasis (all P<0.05). Only tumor size (P=0.001), number of positive SLN (P=0.000), nuclear grade (P=0.008) and lymphovascular invasion (P=0.001) were significant independent predictors for the NSLN metastasis. The trend of actual probability in various decile groups was comparable to the predicted probability. The MSKCC nomogram presented a ROC value of 0.765. Patients with predictive values lower than 10% (51/412,12.4% ) have a frequency of NSLN metastasis of 5.9% (3/51). Conclusion The MSKCC nomogram can provide an accurate prediction of the probability of NSLN metastasis, and give a reference basis about the axillary lymph node dissection (ALND). ALND could be avoided in patients with the predictive values lower than 10%.关键词
乳腺癌/前哨淋巴结/非前哨淋巴结/MSKCC列线图Key words
breast cancer/sentinel lymph node/non-sentinel lymph node/MSKCC nomogram分类
医药卫生引用本文复制引用
邱鹏飞,王春建,张朝蓬,刘广,刘娟娟,王永胜,刘雁冰,李永清,周正波,陈鹏,赵桐,孙晓..乳腺癌非前哨淋巴结转移相关因素及其列线图验证性研究[J].中国实用外科杂志,2012,32(11):945-949,5.基金项目
山东省科学技术发展计划项目(2009GG10002019) （2009GG10002019）
山东省医药卫生科技发展计划项目重点项目(2011HD012) （2011HD012）
