在早期的侵袭性叶状癌症中轴节点的积极性:对哨兵淋巴结的影响 淋巴结活检 遗漏
Lorenzo Scardina1, Sabatino D'Archi2, Cristina Accetta2
1Breast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. lorenzo.scardina@policlinicogemelli.it.
Annals of surgical oncology
|March 12, 2026
概括
大约20%的早期侵袭性叶囊癌 (ILC) 患者有隐藏的淋巴结转移. 病理性瘤大小是主要的预测因素,这表明哨兵淋巴结活检 (SLNB) 对于ILC的关分期至关重要.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 哨兵淋巴结活检 (SLNB) 遗漏被认为是早期乳腺癌.
- 侵袭性叶状癌 (ILC) 在试验中代表性不足,人们担心结节转移率更高.
- 在ILC患者中,部低位化是被认为是SLNB遗漏的潜在风险.
研究的目的:
- 为了评估结节转移在早期阶段的患病率,临床结节阴性ILC.
- 在这个特定的患者亚组中确定结节转移的预测因子.
- 评估在ILC中省略SLNB的影响.
主要方法:
- 对491名ER+/HER2-早期ILC患者的回顾性分析.
- 纳入标准:临床T1,临床节点阴性,接受乳腺保护手术 (2004-2024年).
- 排除标准:新辅助疗法,瘤大于2厘米,先前的转移性疾病.
主要成果:
- 在491名患者中,99名患者 (20.2%) 患有结节转移 (pN1mi-pN3).
- 病理性瘤大小与关节参与有显著的相关性 (p=0.004).
- 组织学亚型和更年期状态不是显著的预测因素,尽管多态ILC显示数字上更高的率.
结论:
- 隐藏的关节结节转移在大约20%的早期,临床结节阴性ILC患者中存在.
- 病理性瘤的大小是ILC结节参与的主要决定因素.
- 在ILC中SLNB遗漏的风险是轴突的低阶段;在预期数据之前,SLNB对这个子组仍然至关重要.
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