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目的对区域淋巴结转移的乳腺癌患者进行临床病理多因素预后分析。方法选择２０个可能对区域淋巴结转移的乳腺癌患者预后产生影响的非重复特征的临床病理因素，通过计算机，采用累计生存率及ＣＯＸ多因素分析模型，进行单因素及多因素的预后分析。结果在选取的２０个因素中，月经状况、初潮年龄、病程、活检方式、术后内分泌治疗、活检时间与生存率相关，但多因素分析则无关；而妊娠次数、肿瘤大小、手术方式、内乳淋巴结情况、腋淋巴结转移数目、皮肤累及情况、病理类型、术后化疗、术后放疗、术前放疗是影响区域淋巴结转移患者生存率的独立因素。结论用临床病理资料对区域淋巴结转移的乳腺癌患者进行预后分析，发现局部晚期的乳腺癌患者预后最差；选择性地局部扩大手术范围清扫或探查内乳淋巴结情况不仅对预测预后提供帮助，而且能提高生存率；术后辅助化疗能提高淋巴结阳性乳腺癌患者的生存率；非选择性的内分泌治疗并不能提高生存率，其作用有待进一步随机对照研究
Objective To analyze the clinical and pathological multifactorial prognosis of breast cancer patients with regional lymph node metastasis. Methods The clinicopathological factors of 20 non-repeated features that may affect the prognosis of breast cancer patients with regional lymph node metastasis were selected. Through computer, the cumulative survival rate and multivariate analysis model of COX were used to analyze the univariate and multivariate prognostic factors. Results Of the 20 factors selected, the menstrual status, menarche age, duration, biopsy, postoperative endocrine therapy, biopsy time, and survival rate were related, but the multivariate analysis was irrelevant; and the number of pregnancies, tumor size, surgical methods, internal Breast lymph node status, number of axillary lymph node metastases, skin involvement, pathological type, postoperative chemotherapy, postoperative radiotherapy, and preoperative radiotherapy were independent factors influencing the survival rate of regional lymph node metastases. Conclusions Prognostic analysis of breast cancer patients with regional lymph node metastases using clinicopathologic data revealed that patients with locally advanced breast cancer had the worst prognosis. Selectively expanding the scope of surgical evacuation or probing the internal mammary lymph nodes not only helps predict prognosis, but also It can improve the survival rate; postoperative adjuvant chemotherapy can improve the survival rate of patients with lymph node positive breast cancer; non-selective endocrine therapy can not improve the survival rate, its role needs to be further randomized controlled study