■分析中国T1型乳腺癌患者的临床病理危险因素和区域淋巴结转移(LNM)的规律,以及对总生存期(OS)和无病生存期(DFS)的影响。
■在1999年至2020年之间,符合单侧纳入标准的乳腺癌患者,没有远处转移部位,并对T1期浸润性导管癌进行回顾性分析。从病历中检索临床病理特征。使用Kaplan-Meier方法和校正的Cox比例风险模型进行生存分析。
■我们招募了11,407名符合条件的患者作为发现队列,以探索LNM的危险因素,并招募了3484名T1N0期患者作为生存分析队列,以确定这些危险因素对OS和DFS的影响。与N-状态患者相比,N+状态的患者年龄较小,肿瘤较大,更高的Ki67水平,更高等级,更高的HR+和HER2+百分比,和较高的管腔B和HER2阳性亚型百分比。Logistic回归分析显示,年龄是LNM的保护因素,肿瘤大小/高级别/HR+和HER2+危险因素。与有限的LNM(N1)患者相比,广泛的LNM(N2/3)患者有较大的肿瘤大小,更高的Ki67水平,更高等级,较高的HR-和HER2+百分比,和较低的腔A型亚型百分比。Logistic回归显示HR+是广泛LNM的保护因素和肿瘤大小/更高级别/HER2+危险因素。Kaplan-Meier分析表明,等级是OS和DFS的预测因子;HR是OS的预测因子,但不是DFS。使用Cox回归模型的多变量生存分析表明,年龄和Ki67水平是T1N0期患者DFS的OS和分级和HER2状态的预测因子。
■在T1乳腺癌患者中,N+和N+患者之间有一些差异,有限的LNM和广泛的LNM患者。此外,HR+在区域LNM中起着双重作用。在没有LNM的患者中,年龄和Ki67水平是OS的预测因素,分级和HER2是DFS的预测因子。
UNASSIGNED: To analyze clinicopathological risk factors and regular pattern of regional lymph node metastasis (LNM) in Chinese patients with T1 breast cancer and the effect on overall survival (OS) and disease-free survival (DFS).
UNASSIGNED: Between 1999 and 2020, breast cancer patients meeting inclusion criteria of unilateral, no distant metastatic site, and T1 invasive ductal carcinoma were reviewed. Clinical pathology characteristics were retrieved from medical records. Survival analysis was performed using Kaplan-Meier methods and an adjusted Cox proportional hazards model.
UNASSIGNED: We enrolled 11,407 eligible patients as a discovery cohort to explore risk factors for LNM and 3484 patients with stage T1N0 as a survival analysis cohort to identify the effect of those risk factors on OS and DFS. Compared with patients with N- status, patients with N+ status had a younger age, larger tumor size, higher Ki67 level, higher grade, higher HR+ and HER2+ percentages, and higher luminal B and HER2-positive subtype percentages. Logistic regression indicated that age was a protective factor and tumor size/higher grade/HR+ and HER2+ risk factors for LNM. Compared with limited LNM (N1) patients, extensive LNM (N2/3) patients had larger tumor sizes, higher Ki67 levels, higher grades, higher HR- and HER2+ percentages, and lower luminal A subtype percentages. Logistic regression indicated that HR+ was a protective factor and tumor size/higher grade/HER2+ risk factors for extensive LNM. Kaplan-Meier analysis indicated that grade was a predictor of both OS and DFS; HR was a predictor of OS but not DFS. Multivariate survival analysis using the Cox regression model demonstrated age and Ki67 level to be predictors of OS and grade and HER2 status of DFS in stage T1N0 patients.
UNASSIGNED: In T1 breast cancer patients, there were several differences between N- and N+ patients, limited LNM and extensive LNM patients. Besides, HR+ plays a dual role in regional LNM. In patients without LNM, age and Ki67 level are predictors of OS, and grade and HER2 are predictors of DFS.