血管细胞黏附分子-1评估乳腺癌乳腔镜腋窝淋巴结清扫手术血液转移风险的临床研究  

Clinical study on circulating VCAM-1 to evaluate the metastasis risk of mastoscopic axillary lymph node dissection

作　　者：骆成玉[1] 范克民 葛沙沙[1] 崔智淼 Luo Chengyu Fan Kemin Ge Shasha Cui Zhimiao(Breast Minimally lnvasive Center, Fuxing Hospital, Capital Medical University, Beijing 100038, China)

机构地区：[1]首都医科大学附属复兴医院乳腺微创中心,北京100038

出　　处：《首都医科大学学报》2017年第2期308-312,共5页Journal of Capital Medical University

基　　金：基金项目:北京市科学技术委员会"首都临床特色应用研究"(Z131107002213145)~~

摘　　要：目的佐证乳腺癌乳腔镜腋窝淋巴结清扫手术在肿瘤学方面的安全性。方法采用随机前瞻临床对照研究,将2014年1月1日至2015年7月31日间于首都医科大学附属复兴医院乳腺微创中心的治疗的104例乳腺癌病人,利用抽签法随机分成乳腔镜清扫(乳腔镜组)和常规腋窝淋巴结清扫术(常规组),各52例。于术前、术后1、3、5 d抽取病人血清标本。采用ELISA方法,分析2组病人血清中血管细胞黏附分子(vascular cell adhesion molecular-1,VCAM-1)表达。结果常规组病人血清VCAM-1浓度手术后1、3、5 d分别为(51.74±1.37)ng/mL、(52.64±1.24)ng/mL、(52.22±1.29)ng/mL,较手术前(56.56±1.24)ng/mL显著下降,乳腔镜组病人血清VCAM-1浓度手术后1、3、5 d分别为(53.24±1.21)ng/mL、(52.07±1.34)ng/mL、(48.99±1.27)ng/mL,较手术前(58.66±0.95)ng/mL显著下降。乳腔镜组手术后血清VCAM-1浓度低于常规组(结果同上),但差异不具统计学意义(P>0.05)。结论乳腔镜腋窝淋巴结清扫手术后病人血清VCAM-1浓度变化与常规清扫差异无统计学意义,该手术并没有显示导致肿瘤血液转移风险的增加。Objective To elucidate the change after mastoscopic axillary lymph node dissection （MALND） and conventional axillary lymph node dissection （CALND） and further prove the safety of MALND.Methods 104 breast cancer patients （January 1st,2014 to July 31 st,2015） from Breast Minimally Invasive Center,Fuxing Hospital,Capital Medical University who were undergone ALND were randomly divided into two groups：CALND（n=52） and MALND（n=52）.The peripheral blood samples were respectively collected in pre-operation and 1,3,5 days after operation.The circulating levels of vascular cell adhesion molecular-1 （VCAM-1） in blood were analyzed by ELISA.Results Circulating VCAM-1 levels of CALND group on postoperative 1 d（51.74±1.37）ng/mL,3 d（52.64±1.24）ng/mL,5 d（52.22±1.29）ng/mL decreased significantly than that of pre-operation （56.56±1.24）ng/mL.And the figures of MALND group turn to be（53.24±1.21）ng/mL,（52.07±1.34）ng/mL,（48.99±1.27）ng/mL,（58.66±0.95） ng/mL.The VCAM-1 levels of MALND group is lower than that of CALND,but there was no statistical difference between the two groups （P〉0.05）.Conclusion The change of circulating VCAM-1of patients after MALND is same to that of CALND.There is no evidence that MALND increases the risk of blood dissemination of tumor.

关 键 词：乳腺癌 乳腔镜腋窝淋巴结清扫 细胞间黏附分子-1 

分 类 号：R65[医药卫生—外科学]