前哨淋巴结活检术在乳腺癌手术中的应用  

Sentinel lymph node biopsy in breast cancer surgery

作　　者：吴开林[1] 林龙[1] 赵国栋[2] WU Kai-lin LIN Long ZHAO Guo-dong(Department of General Surgery, Hainan Traditional Chinese Medicine Hospital Department of Gastrointestinal Surgery, Haikou People＇s Hospital, Haikou 570100, China)

机构地区：[1]海南省中医院普外科 [2]海口市人民医院胃肠外科,海口570100

出　　处：《中国肿瘤临床与康复》2017年第5期560-562,共3页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：海南省自然科学基金(811215)

摘　　要：目的探讨乳腺癌手术治疗中前哨淋巴结活检术的应用价值。方法选取2013年2月至2016年12月间海南省中医院收治的80例接受乳腺癌手术治疗的患者,采用随机数表法分为观察组(接受前哨淋巴结活检术)与对照组(未接受前哨淋巴结活检术),每组40例。比较两组患者治疗前后血清肿瘤标志物水平和不良反应情况。结果治疗后观察组患者血清肿瘤标志物癌脴抗原(CEA)、糖类抗原(CA153)和糖类抗原(CA125)分别为(2.36±0.56)ng/ml、(13.21±5.53)U/ml和(15.64±5.43)U/ml,对照组患者分别为(3.28±0.86)ng/ml、(14.86±4.53)U/ml和(16.98±6.69)U/ml,两组均较治疗前明显降低,且观察组患者较对照组降低更多,差异均有统计学意义(均P<0.05)。对照组患者皮下积液、上肢水肿和上肢活动受限等并发症发生率合计为40.0%,观察组患者为7.5%,两组比较,差异有统计学意义(P<0.05)。结论前哨淋巴结活检辅助乳腺癌手术能够避免不必要的淋巴结清扫,减少机体损伤,降低不良反应发生率,且不会对手术效果造成影响,可在临床中推广。Objective To discuss the significnce of sentinel lymph node biopsy in breast cancer surgery. Methods Select 80 patients with breast cancer undergoing surgery at Hainan Traditional Chinese Medicine Hospital from February 2013 to December 2016. Using a random number table, patients were di- vided into an observation group （with sentinel lymph node biopsy ） and a control group （without sentinel lymph node biopsy） with 40 patients in each group. Serum tumor markers as well as adverse reactions were compared between the two groups before and after treatment. Results After treatment, careino-embryonic antigen （CEA）, carbohydrate antigen 153 （CA153） and carbohydrate antigen 125 （CA125） levles were （2. 36 ±0. 56） ng/ml, （ 13.21±5.53 ） U/ml and （ 15.64 ±5.43 ） U/ml, respectively for observation group and （3.28±0. 86） ng/ml, （ 14. 86 ± 4. 53 ） U/ml and （ 16. 98 ±6. 69 ） U/ml, respectively for the control group. Serum tumor markers levels significantly decreased in both groups compared with before treatment （ P 〈 0. 05 ）. The incidence of subcutaneous effusion, upper extremity edema and upper limb activity limita- tion added up to 40% for the control group and 7.5% for the observation group （ P 〈 0. 05 ）. Conclusion Sentinel lymph node biopsy as an adjuvant therapy for breast cancer can avoid unnecessary lymph node dis- section, lessen body damage and reduce the incidence of adverse reactions without major effect on the sur- gery. Therefore, it can be further promoted.

关 键 词：前哨淋巴结 活检 乳腺肿瘤 

分 类 号：R737.9[医药卫生—肿瘤]