Recently, there has been controversy about the relationship between the number of lymph nodes removed and survival of patients diagnosed with lymph node-negative breast cancer. To assess this relationship, 603 cases o...Recently, there has been controversy about the relationship between the number of lymph nodes removed and survival of patients diagnosed with lymph node-negative breast cancer. To assess this relationship, 603 cases of lymph node-negative breast cancer with a median of 126 months of follow-up data were studied. Patients were stratified into two groups(Group A, 10 or fewer tumor-free lymph nodes removed; Group B, more than 10 tumor-free lymph nodes removed). The number of tumor-free lymph nodes in ipsilateral axillary resections as well as 5 other disease parameters were analyzed for prognostic value. Our results revealed that the risk of death from breast cancer was significantly associated with patient age, marital status, histologic grade, tumor size, and adjuvant therapy. The 5- and 10-year survival rates for patients with 10 or fewer tumor-free lymph nodes removed was 88.0% and 66.4%, respectively, compared with 69.2% and 51.1%, respectively, for patients with more than 10 tumor-free lymph nodes removed. For patients with 10 or fewer tumor-free lymph nodes removed, the adjusted hazard ratio(HR) for risk of death from breast cancer was 0.579(95% confidence interval, 0.492-0.687, P < 0.001), independent of patient age, marital status, histologic grade, tumor size, and adjuvant therapy. Our study suggests that the number of tumor-free lymph nodes removed is an independent predictor in cases of lymph node-negative breast cancer.展开更多
目的:通过检测三阴性乳腺癌(triple-negative breast cancer,TNBC)组织中肿瘤相关中性粒细胞(tumor-associated neutrophils,TANs)浸润密度及程序性死亡配体-1(PD-L1)的表达情况来分析二者的相关性,并探究其临床意义。方法:选取141例我...目的:通过检测三阴性乳腺癌(triple-negative breast cancer,TNBC)组织中肿瘤相关中性粒细胞(tumor-associated neutrophils,TANs)浸润密度及程序性死亡配体-1(PD-L1)的表达情况来分析二者的相关性,并探究其临床意义。方法:选取141例我院三阴性乳腺癌患者组织标本,使用抗体CD66b作为TANs的标记物,通过免疫组织化学法检测TNBC肿瘤组织内TANs浸润和PD-L1表达的情况。采用Pearson积差相关或Spearman等级相关分别分析TANs浸润密度和PD-L1表达与临床病理特征的相关性,以及TNBC肿瘤组织内TANs浸润密度与PD-L1阳性表达之间的相关性;采用Kaplan-Meier曲线对TNBC患者进行生存分析。结果:TANs高浸润密度与高Ki67增殖指数、高组织学分级以及淋巴结转移均呈正相关(P<0.05)。PD-L1表达与高Ki67增殖指数及高组织学分级均呈正相关(P<0.05)。TNBC中TANs的浸润密度与PD-L1阳性表达呈正相关(P<0.05)。生存分析显示,TANs浸润密度和PD-L1表达均与TNBC患者的无进展生存期呈负相关(P<0.05)。结论:TNBC肿瘤组织内TANs浸润密度和PD-L1表达与多项临床病理特征以及不良预后密切相关,这提示TANs及PD-L1可作为TNBC预后评估的重要指标,并为探索TNBC免疫治疗潜在靶点提供研究依据。展开更多
基金supported by a grant from the National Natural Science Foundation of China (No. 81172165)
文摘Recently, there has been controversy about the relationship between the number of lymph nodes removed and survival of patients diagnosed with lymph node-negative breast cancer. To assess this relationship, 603 cases of lymph node-negative breast cancer with a median of 126 months of follow-up data were studied. Patients were stratified into two groups(Group A, 10 or fewer tumor-free lymph nodes removed; Group B, more than 10 tumor-free lymph nodes removed). The number of tumor-free lymph nodes in ipsilateral axillary resections as well as 5 other disease parameters were analyzed for prognostic value. Our results revealed that the risk of death from breast cancer was significantly associated with patient age, marital status, histologic grade, tumor size, and adjuvant therapy. The 5- and 10-year survival rates for patients with 10 or fewer tumor-free lymph nodes removed was 88.0% and 66.4%, respectively, compared with 69.2% and 51.1%, respectively, for patients with more than 10 tumor-free lymph nodes removed. For patients with 10 or fewer tumor-free lymph nodes removed, the adjusted hazard ratio(HR) for risk of death from breast cancer was 0.579(95% confidence interval, 0.492-0.687, P < 0.001), independent of patient age, marital status, histologic grade, tumor size, and adjuvant therapy. Our study suggests that the number of tumor-free lymph nodes removed is an independent predictor in cases of lymph node-negative breast cancer.
文摘目的:通过检测三阴性乳腺癌(triple-negative breast cancer,TNBC)组织中肿瘤相关中性粒细胞(tumor-associated neutrophils,TANs)浸润密度及程序性死亡配体-1(PD-L1)的表达情况来分析二者的相关性,并探究其临床意义。方法:选取141例我院三阴性乳腺癌患者组织标本,使用抗体CD66b作为TANs的标记物,通过免疫组织化学法检测TNBC肿瘤组织内TANs浸润和PD-L1表达的情况。采用Pearson积差相关或Spearman等级相关分别分析TANs浸润密度和PD-L1表达与临床病理特征的相关性,以及TNBC肿瘤组织内TANs浸润密度与PD-L1阳性表达之间的相关性;采用Kaplan-Meier曲线对TNBC患者进行生存分析。结果:TANs高浸润密度与高Ki67增殖指数、高组织学分级以及淋巴结转移均呈正相关(P<0.05)。PD-L1表达与高Ki67增殖指数及高组织学分级均呈正相关(P<0.05)。TNBC中TANs的浸润密度与PD-L1阳性表达呈正相关(P<0.05)。生存分析显示,TANs浸润密度和PD-L1表达均与TNBC患者的无进展生存期呈负相关(P<0.05)。结论:TNBC肿瘤组织内TANs浸润密度和PD-L1表达与多项临床病理特征以及不良预后密切相关,这提示TANs及PD-L1可作为TNBC预后评估的重要指标,并为探索TNBC免疫治疗潜在靶点提供研究依据。