吸脂法腔镜腋窝淋巴结清除术野脱落细胞学研究  

Cytological study on exfoliated cells in operation field by E-ALND

作　　者：郭美琴[1] 姜军[1] 杨新华[1] 范林军[1] 贺青卿[1] 张毅[1] 

机构地区：[1]第三军医大学西南医院乳腺疾病中心,重庆400038

出　　处：《中华肿瘤防治杂志》2009年第9期710-712,共3页Chinese Journal of Cancer Prevention and Treatment

基　　金：全军医学科学技术研究"十一五"计划课题资助项目(06 MA191);第三军医大学西南医院临床研究专项基金资助项目(SWH2004013;SWH2005B007)

摘　　要：目的：研究乳腺癌腔镜腋窝淋巴结清除手术野脱落细胞学，证实该技术的肿瘤安全性。方法：对49例实施腔镜腋窝淋巴结清除（E—ALND）和43例实施常规开放腋窝淋巴结清除术（ALND）的乳腺癌患者手术野冲洗液，在去除红细胞处理后进行脱落细胞学检查。结果：49例实施E—ALND的患者，3例原位癌，46例浸润性乳腺癌，其中17例发生腋窝淋巴结癌转移的患者手术野冲洗液均未找到癌细胞；43例对照组患者，1例原位癌，42例浸润性乳腺癌，其中16例发生腋窝淋巴结转移，2例术前未进行新辅助化疗的患者，1例手术野冲洗液找到癌细胞。结论：Ⅰ～Ⅱ期临床腋窝无肿大淋巴结的乳腺癌，腔镜腋窝淋巴结清除手术不会比常规开放手术增加术中肿瘤细胞脱落种植的可能性。OBJECTIVE： To study the cytological examination of exfoliated cells in the operation field by endoscopic axillary lymphy node dissection after lipsuction （E ALND）, and to provide evidence of the oneological safety about this technique. METHODS： The cytological examination in rinse solution of operation field was done in 49 cases of patient with breast cancer treated by E-ALND and 43 cases of patients treated by ALND. Before cytological examination the red blood cells in rinse solution were lyses first. RESULTS： No cancer cell was found in surgical field by E-ALND. These 49 patients concluded 3 breast cancer in su, 46 invasive breast cancer in which 17 cases of axillary lymphy nodes were metastasis; Only one of two patients without preoperative adjunctive chemotheropy underwent traditional ALND was positive in surgical field. These 43 patients included 1 breast cancer in su, 42 in vasive breast cancer in which 16 cases of axillary lymphy nodes were metastasis. CONCLUSIONS： For the case of Ⅰ -- Ⅱ stage breast cancer, no campable nodes in the axillary in clinic, the technique of E ALND does not induced more exfoliated cancer cells in the surgical field than conventional surgery. It would be more warranted if enlarged speci- mens and set up subgroups strictly.

关 键 词：淋巴结切除术 乳腺肿瘤 细胞学 

分 类 号：R737.9[医药卫生—肿瘤]