保乳综合治疗并前哨淋巴结活检治疗早期乳腺癌(1)
【摘要】 目的：探讨保乳综合治疗并前哨淋巴结活检(Sentinel lymph node biopsy， SLNB)在早期乳腺癌治疗中的应用价值。方法：临床纳入早期乳腺癌患者70例，患者均有保乳意愿，患者需在自愿的基础上签署SLNB手术治疗同意书。患者在保乳手术的同时进行SLNB，根据术中前哨淋巴结(Sentinel lymph node， SLN)快速冰冻病理切片检查的结果，对于SLN阳性者(设定为对照组)进行规范的腋窝淋巴结清扫(Axillary lymph node dissection， ALND)，对于SLN阴性者(设定为试验组)不进行进一步腋窝淋巴结清扫术。结果：试验组患者手术时间、住院时间、腋窝引流时间分别为(75.51±6.65)min、(11.76±1.49)d、(3.92±0.61)d，对照组患者分别为(117.60±5.46)min、(15.69±1.33)d、(7.65±0.53)d，两组比较差异均有统计学意义(P<0.05)。SLN活检成功率为100%，其中，SLN阳性25例，SLN阴性45例，检测准确率为100%，假阳性率为0。术后对患者进行20～55个月的临床随访，平均随访42个月。试验组术后并发症发生率明显低于对照组，两组比较差异有统计学意义(P<0.05)。两组患者术后3年生存率均为100%，无瘤生存率均为100%。结论：SLND为早期乳腺癌保乳手术方式的选择提供了重要的临床参考依据，前哨淋巴结活检并保乳综合治疗是早期乳腺癌一种很好的治疗手段，有效减轻手术创伤和术后并发症。
, http://www.100md.com
【关键词】 保乳； 前哨淋巴结活检； 早期乳腺癌
【Abstract】 Objective： To investigate the value of breast conserving therapy and sentinel lymph node biopsy (Sentinel lymph node biopsy， SLNB) in the treatment of early breast cancer. Method： 70 patients with early breast cancer were selected in our hospital， all of them had SLNB during breast cancer surgery， according to intraoperative sentinel lymph node (Sentinel lymph node， SLN) rapid frozen section examination results， for SLN positive patients received breast conserving surgery modified radical mastectomy with standard axillary lymph node dissection (Axillary lymph node dissection， ALND)， for SLN negative， then breast conserving combined with simplified ALND (only resection of pectoralis minor lateral group， Level Ⅰ). Result： The simplify operation time， the patients hospitalization time， axillary drainage time was (75.51±6.65)min， (11.76±1.49)d， (3.92±0.61)d， the standard group was (117.60±5.46)min， (15.69±1.33)d， (7.65±0.53)d， the index had significant difference (P<0.05). The success rate of SLN biopsy was 100%. Among them， 25 cases were SLN positive， 45 SLN negative patients， the detection accuracy rate was 100%， false positive rate was 0. Postoperative clinical follow-up was 20-55 months for the patients with a mean follow-up of 42 months. The overall survival rate of the two groups after 3 year was both 100%， disease free survival rate was 100%. Conclusion： SLNB provides an important choice for the surgical treatment choices for early breast cancer.
, 百拇医药
【Key words】 Breast conserving； Sentinel lymph node biopsy； Early breast cancer
目前，各类癌症的发病率居高不下，乳腺癌是女性排行第一的恶性肿瘤，其发病率呈现逐年上升的趋势，特别是40岁到绝经期前是乳腺癌的高发年龄[1]。对于早期乳腺癌患者，均建议进行手术治疗[2]。传统的乳腺癌改良根治术包括患侧乳房切除及腋窝淋巴结清扫(Axillary lymph node dissection， ALND)[3]，造成患者生理上的缺陷，同时给患者的心理造成严重的不良影响；而且ALND对患者的创伤加大，术后并发症相对较多，一定程度上影响了患者的生活质量[4]。目前，乳腺癌保留乳房治疗(Breast Conserving Treatment，BCT)已成为欧美国家及我国部分地区临床早期乳腺癌的规范治疗，多项研究认为保留乳房治疗与改良根治术具有相同的疗效。前哨淋巴结(Sentinel lymph node， SLN)属于原发肿瘤转移的第1站区域淋巴结[5-6]。随着临床研究的深入，循证医学证据证实了乳腺癌前哨淋巴结活检(SLNB)的安全性，SLNB可以提供准确的腋窝淋巴结分期，前哨淋巴结(SLN)阴性患者行SLNB替代腋窝淋巴清扫术局部复发率和并发症发生率很低。为进一步探讨保乳综合治疗并前哨淋巴结活检治疗早期乳腺癌的临床价值，笔者对本院70例早期乳腺癌患者进行了临床资料的回顾性分析，先报告如下。, http://www.100md.com(黄志华等)
, http://www.100md.com
【关键词】 保乳； 前哨淋巴结活检； 早期乳腺癌
【Abstract】 Objective： To investigate the value of breast conserving therapy and sentinel lymph node biopsy (Sentinel lymph node biopsy， SLNB) in the treatment of early breast cancer. Method： 70 patients with early breast cancer were selected in our hospital， all of them had SLNB during breast cancer surgery， according to intraoperative sentinel lymph node (Sentinel lymph node， SLN) rapid frozen section examination results， for SLN positive patients received breast conserving surgery modified radical mastectomy with standard axillary lymph node dissection (Axillary lymph node dissection， ALND)， for SLN negative， then breast conserving combined with simplified ALND (only resection of pectoralis minor lateral group， Level Ⅰ). Result： The simplify operation time， the patients hospitalization time， axillary drainage time was (75.51±6.65)min， (11.76±1.49)d， (3.92±0.61)d， the standard group was (117.60±5.46)min， (15.69±1.33)d， (7.65±0.53)d， the index had significant difference (P<0.05). The success rate of SLN biopsy was 100%. Among them， 25 cases were SLN positive， 45 SLN negative patients， the detection accuracy rate was 100%， false positive rate was 0. Postoperative clinical follow-up was 20-55 months for the patients with a mean follow-up of 42 months. The overall survival rate of the two groups after 3 year was both 100%， disease free survival rate was 100%. Conclusion： SLNB provides an important choice for the surgical treatment choices for early breast cancer.
, 百拇医药
【Key words】 Breast conserving； Sentinel lymph node biopsy； Early breast cancer
目前，各类癌症的发病率居高不下，乳腺癌是女性排行第一的恶性肿瘤，其发病率呈现逐年上升的趋势，特别是40岁到绝经期前是乳腺癌的高发年龄[1]。对于早期乳腺癌患者，均建议进行手术治疗[2]。传统的乳腺癌改良根治术包括患侧乳房切除及腋窝淋巴结清扫(Axillary lymph node dissection， ALND)[3]，造成患者生理上的缺陷，同时给患者的心理造成严重的不良影响；而且ALND对患者的创伤加大，术后并发症相对较多，一定程度上影响了患者的生活质量[4]。目前，乳腺癌保留乳房治疗(Breast Conserving Treatment，BCT)已成为欧美国家及我国部分地区临床早期乳腺癌的规范治疗，多项研究认为保留乳房治疗与改良根治术具有相同的疗效。前哨淋巴结(Sentinel lymph node， SLN)属于原发肿瘤转移的第1站区域淋巴结[5-6]。随着临床研究的深入，循证医学证据证实了乳腺癌前哨淋巴结活检(SLNB)的安全性，SLNB可以提供准确的腋窝淋巴结分期，前哨淋巴结(SLN)阴性患者行SLNB替代腋窝淋巴清扫术局部复发率和并发症发生率很低。为进一步探讨保乳综合治疗并前哨淋巴结活检治疗早期乳腺癌的临床价值，笔者对本院70例早期乳腺癌患者进行了临床资料的回顾性分析，先报告如下。, http://www.100md.com(黄志华等)