病理切缘和骨桥蛋白组织表达为特征的分子切缘在保乳手术中的应用研究  

Research of safe range of breast-conserving surgery on pathological margin and molecular margin of osteopontin expression

作　　者：郇金亮[1] 秦贤举[1] 周强[1] 潘晓峰[1] 赵志东[1] 诸灵[1] 张军初[2] 

机构地区：[1]上海市第八人民医院,200235 [2]第二军医大学附属长征医院

出　　处：《山西医药杂志（上半月）》2013年第11期1216-1218,共3页Shanxi Medical Journal

基　　金：上海市徐汇区医学科研课题(SHXH201011)

摘　　要：目的通过术中组织冰冻切片检查和相应组织骨桥蛋白水平表达检测,找出病理检查难以发现的隐性癌灶,为临床实施保乳手术界定切缘提供理论依据。方法距瘤体组织0.5、1.0、1.5、2.0、2.5、3.0cm分别切除标本行冰冻切片检查,实时荧光定量逆转录聚合酶链反应(qRT-PCR)技术检测骨桥蛋白表达。结果癌旁0.5、1.0cm处骨桥蛋白表达阳性比例高于1.5cm处(P<0.05),1.5cm与2.0cm处之间差异无统计学意义(P>0.05),其中有2个样本距离瘤组织边缘3cm处骨桥蛋白仍表达阳性。结论早期乳腺癌保乳手术切缘切除范围1.5cm为安全切缘,但合适的切缘范围应有个体差异,取决于患者年龄、细胞组织学和自身选择。Objective To provide evidence for the surgical marginal distance from tumor edge in clinical breast-conserving operation through examining the pathologic elusive hidden cancerous foci range by frozen section examination and osteopontin expression level .Methods The specimens located at different distances （0.5 ,1.0 , 1.5 ,2.0 ,2.5 ,3.0 cm） from tumor edge were detected by using frozen section examination and qRT-PCR tech-nique for osteopontin expression .Results The positive rate of risk factors at 0.5 cm and 1.0 cm from tumor edge was significantly higher than that of 1.5 cm（P〈0.05） .However ,there is no significant difference between the positive rate of 2.0 cm and 1.5 cm （P〉 0.05） .Risk factors still existed in 2 specimens at 3.0 cm from tumor edge ,and the osteopontin expression of their primary tumors were still positive .Conclusion The resection should be extended up to 1.5 cm from tumor edge in breast-conserving surgery for those patients with primary breast cancer .Alternatively ,detailed longitudinal data was needed to balance the value and the cost of wide margins . Until further data are available ,the desirable margin width will be various depending on ages ,histological expres-sion and patient preference .

关 键 词：乳腺肿瘤 乳房切除术 区段 冷冻切片 手术切缘 骨桥蛋白 

分 类 号：R737.9[医药卫生—肿瘤]