乳腺癌术后即刻乳房再造疗效临床研究  

Clinical Study of Immediate Breast Reconstruction after Breast Cancer Surgery

作　　者：王会东[1] 张军[1] 王涵 

机构地区：[1]潍坊市人民医院乳腺外科,山东潍坊261041 [2]潍坊医学院外科学教研室

出　　处：《潍坊医学院学报》2017年第5期354-356,共3页Acta Academiae Medicinae Weifang

摘　　要：目的分析乳腺癌患者接受乳腺癌根治术后即刻乳房再造与接受单纯根治性术后的疗效。方法采用配对病例对照研究方法,对2008年1月~2016年2月间在潍坊市人民医院乳腺外科接受手术的乳腺癌患者,根据乳腺癌TNM分期、腋窝淋巴结状态、雌激素受体状态、人表皮生长因子受体-2状态4个变量对乳腺癌术后即刻乳房修复再造患者(再造组)和单纯改良根治术的患者(对照组)进行匹配,比例为1∶2。配对结果为再造组患者30例,对照组患者60例。再造组中位随访时间为38个月,对照组为48.3个月。比较两组的总体生存率和无病生存率,评估即刻乳房再造手术的美容效果。结果两组中均无患者出现局部复发。再造组患者中2例出现远处转移,中位转移时间为6个月;60例对照组患者中有6例出现远处转移,中位转移时间为9个月。随访患者死亡6例,其中再造组2例,对照组4例,患者均死于乳腺癌远处转移。即刻再造组与改良根治术组间总体生存率和无病生存率差异无统计学意义(P>0.05)。结论通过合理的选择手术适应证和手术方法,乳腺癌根治术后即刻乳房再造可以取得与单纯改良根治手术同样的治疗效果,而且在保证治疗效果的同时能够获得较好的美容效果,对于乳腺癌患者是一种理想的治疗方式。Objective To analyze the efficacy of immediate breast reconstruction and modified radical mastectomy in women with breast cancer,and to compare the two methods. Methods A matched retrospective case-control study using data onpatients derived from a prospectively collected breast cancer database was conducted. The database included patients who received IBR or MRM from Jan 2008 to Feb2016 in Weifang People＇s Hospital. The match was conducted according to four variables ： TNM stage,axillary lymph node status,sexcual homone receptor and human epidermal growth factor receptor-2. The match ratio was 1∶ 2. Cases were patients who received IBR（ n = 30）.Control group were patients who received MRM（ n = 60）. Median follow-up for the controls and cases were 38 months and 48. 3 months respectively. The differences of disease free survival and overall survival were compared. And we also analysed the cosmetic result. Results There were no patient local recur in both group. There were two distant-metastasispatient in IBR group and six in MRM group. Six patients were dead of breast cancer metastasis,two in IBR group,the others in MRM group. The overall survival and disease free survival in MRM and IBR patients had no difference（ P 〉0. 05）. Conclusion For appropriate breast maligancy patients,IBR can result in the same effects as modified radical mastectomy,but IBR can not only receive better cosmetic appearances but also improve the quality of life.

关 键 词：乳腺癌 即刻乳房再造 改良根治术 

分 类 号：R655.8[医药卫生—外科学]