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[目的]探索早期乳腺癌胸壁复发的危险因素。[方法]收集2005年8月至2016年3月我院收治的乳腺癌患者的临床资料,入组条件:术后分期T1N0M0、T2N0M0,清扫淋巴结总数≥10枚;且未行术后辅助放射治疗,共入组337例;其中首发转移部位为胸壁者共48例。[结果]单因素分析显示,原发灶大小、癌周血管侵犯、组织学分级、ER/PR表达、内分泌治疗等不同亚组在胸壁复发之间有统计学意义(P<0.05)。Logistic回归多因素分析显示,癌周血管侵犯(+)、组织学分级Grade 3与T1~2N0M0期乳腺癌术后胸壁复发相关(P<0.05)。[结论]乳腺癌术后分期T1~2N0M0的患者中,癌周血管侵犯(+)、组织学分级Grade 3为术后胸壁复发的独立危险因素,此类患者行术后辅助放疗有可能临床获益。
[Objective] To explore the risk factors of chest wall recurrence in early breast cancer. [Methods] The clinical data of breast cancer patients admitted to our hospital from August 2005 to March 2016 were collected. The conditions of the patients were: T1N0M0, T2N0M0, total lymph node dissection≥10 after operation; and no postoperative adjuvant radiotherapy , A total of 337 cases; a total of 48 cases of chest wall metastasis. [Results] Univariate analysis showed that the size of the primary tumor, perivascular vascular invasion, histological grade, expression of ER / PR, endocrine therapy and other subgroups had statistical significance between chest wall recurrence (P <0.05). Logistic regression multivariate analysis showed that perivascular vascular invasion (+) and histological grade Grade 3 were correlated with postoperative chest wall recurrence of T1 ~ 2N0M0 breast cancer (P <0.05). [Conclusion] Peripheral vascular invasion (+) and histological grade Grade 3 are independent risk factors of postoperative chest wall recurrence in patients with postoperative T1 ~ 2N0M0 breast cancer. The postoperative adjuvant radiotherapy may be clinically feasible beneficial.