吡柔比星在乳腺癌患者手术中冲洗创腔的临床价值  

Clinical value of washing the surgical field with pirarubicin in breast cancer

作　　者：亓春玲[1] 

机构地区：[1]泰安市中心医院临床检验中心,山东271000

出　　处：《社区医学杂志》2014年第16期7-9,共3页Journal Of Community Medicine

摘　　要：目的探讨乳腺癌手术创面冲洗液脱落癌细胞阳性率与临床因素的关系,为术中应用吡柔比星杀灭脱落癌细胞的临床价值提供理论依据。方法将2012年6月—2014年1月期间119例行乳腺癌改良根治术的患者随机分为试验组(n=60)和对照组(n=59),对两组患者手术创面冲洗液分别进行脱落癌细胞检查,并将结果与临床因素对比分析;而后试验组应用吡柔比星冲洗,对照组仅用蒸馏水冲洗;之后,观察手术创面冲洗液中脱落癌细胞的阳性率,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 119例患者脱落癌细胞阳性率为36.97%,试验组38.33%、对照组35.59%,差异无统计学意义(P>0.05)。脱落癌细胞阳性率与病理分期、肿瘤大小、有无淋巴结转移有关,差异有统计学意义(P<0.05);试验组用吡柔比星再次冲洗后,脱落癌细胞阳性率为6.6%,对照组为20.3%,差异有统计学意义(P<0.05)。结论乳腺癌手术结束前,应用吡柔比星冲洗手术创面,能有效杀灭术中脱落癌细胞,对病期晚、有淋巴结转移患者尤为必要。Objective To study the relationship between the positive rate of exfoliative cancer cells in the washing liquid of the surgical field and clinical factors of breast cancer, and to provide a theoretical basis for clinical value of using pirarubicin to kill the exfoliative cancer cells in the surgical field. Methods 119 cases with breast cancer treated by modified radical mastectomy from June, 2012 to January, 2014 in our hospital were randomly divided into study group （n = 60） and control group （n = 59）. Exfoliative cancer.cell examination of washing liquid was performed in 119 patients. The results and clinical factors were compared and analyzed. Then the operative wounds of study group were treated with pirarubicin, while the wounds of control group were washed with distilled water only. After that, the positive rates of exfoliative cancer cell in washing liquid of both groups were examined and analyzed by 2,2 test, P 〈 0.05 was considered statistically signifi- cant. Results The positive rate of exfoliative cancer cell in study group and control group was 38.3% and 35.6% respec- tively, the total rate of exfoliative cancer cell was 36.9%, showing no statistically significant difference. （P 〉 0.05） The positive rate of exfoliative cancer cell hadsignificant relationship with pathological stages, the size of tumor, metastasis of lymph nodes. （ P 〈 0.05 ） . After using pirarubicin in the study group, the positive rate of exfoliative cancer cell was only 6.6%, but that of the control group Was 20.3% （P 〈 0.05 ）. Conclusions Before the end of breast cancer surgery, washing the surgical field with pirarubicin can effectively kill or remove the exfoliative breast cancer cells in the surgical field, particularly necessary for patients in later pathological stages or with axillary lymphnodes metastasis.

关 键 词：乳腺癌 吡柔比星 术中冲洗 脱落癌细胞 

分 类 号：R737.9[医药卫生—肿瘤]