科研之友
微信
新浪微博
Facebook
分享链接
摘要
Sentinel lymph node biopsy substituting axillary lymph node dissection has become a routine surgery in many countries but not in China because of the false negative rate. False negative (FN) of sentinel lymph node (SLN) can lead an incorrect assessment of pathological staging. In this study, we retrospectively analyzed the clinic pathological data of 645 breast cancer patients in Shandong Cancer Hospital and Institute from January 2012 to December 2015. True positive (TP), True negative (TN) and FN were identified in 383 patients (59.4%), 215 patients (33.3%) and 39 patients (9.2%), respectively. Among FN patients, about 92.3% of them were found that the positive lymph nodes were in Level I and/or Level II. Negative predictive value was 96.4% (215/223). Accuracy rate was 92.7% (494/598). FN rate was likely to occur in patients who were estrogen receptor (ER) negative, progesterone receptor (PR) negative, human epidermal growth factor 2 (HER2) positive and less than 3 positive axillary lymph nodes (all P<0.05). Among these four molecular subtypes, HER2-enriched subtype is more likely to be FN (P=0.001). A multivariate logistic regression model confirmed that ER status (OR=0.124, P<0.05), HER2 status (OR=3.703, P<0.05) and the numbers of positive lymph nodes (OR=0.009, P<0.05) were all independent factors predicting FN results. For those patients with high risk factors, such as ER negative, PR negative and HER2 positive, dissection of Level I and Level II lymph node may be a relatively safe measure, considering the limited medical conditions, such as unskilled surgeons and poor equipment conditions.
- 出版日期2016
- 单位山东大学
