乳腺区段切除术治疗老年早期乳腺癌的临床分析  

Clinical Effect of Segmental Mastectomy on Early Breat Cancer in the Elderly

作　　者：陆霁 周琨[2] 殷晓星[2] 徐晗[2] 马保金 Lu Ji;Zhou Kun;Yin Xiaoxing;Xu Han;Ma Baojin(Department of General Surgery,Huashan Hospital Affilated to Fudan University,Shanghai,200031;Department of General Surgery,Jing＇an District Central Hospital,Shanghai,200040,P.R.China)

机构地区：[1]复旦大学附属华山医院普外科,上海200031 [2]上海市静安区中心医院普外科,上海200040

出　　处：《老年医学与保健》2018年第3期286-288,共3页Geriatrics & Health Care

摘　　要：目的探讨乳腺区段切除术治疗老年早期乳腺癌的疗效。方法以复旦大学附属华山医院2011年12月—2012年12月普外科诊治的46例老年早期乳腺癌患者为研究对象,所选患者均行乳腺区段切除术,收集并分析患者的一般资料、病理资料、转移复发以及其术后5年生存率等资料。采用免疫组化染色法检测患者生物标记物,包括雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER2)、细胞增殖核抗原Ki67、p53的表达水平。将所有指标进行单因素分析评价老年乳腺癌手术患者预后影响因素。结果 ER/PR阳性者44例,ER及PR均阴性者12例,HER2阴性者44例,阳性2例;Ki67值表达10例,高表达36例;p53阳性11例,阴性35例。所选患者随访时间在12~74个月之间,截止2018年1月,中位随访时间为42个月。患者5年累积乳腺癌特异性DFS为91.0%,OS为90.8%。复发转移因素进行单因素分析,提示Ki67高表达、是否接受内分泌治疗是复发转移的独立危险因素。结论老年早期乳腺患者行乳腺区段切除术疗效显著,具有一定的临床价值。Objective To explore the curative effect of segmental mastectomy on early breat cancer in the elderly. Methods46 elderly with early breat cancer undergoing segmental breat resection during the period from Dec., 2011 to Dec., 2012 in Huashan Hospital were enrolled and the general data, pathological study, metastasis, recurrence and the 5-year postoperative survival were collect and analyzed; the immuno histochemical staining was applied in detecting the expression levels of the biomarkers, including estrogen receptor（ER）, progesterone receptor（PR）, human epidermal growth factor receptor 2（HER2）,cell proliferating nuclear antigen（Ki67）, and p53; all the indexes were studied by univariate analysis and the prognostic factors were evaluated. Results ER/PR positive was found in 44 elderly, ER and PR negative in 12, HER2 negative in 44 while positive in 2, high expression of Ki67 in 10 while low in 36, p53 positive in 11 while negative in 35; he follow-up of all the 46 elderly lasted from 12 to 74 months, were followed up for 12-74 months with average of 42 months by Jan., 2018; the 5-year cumulative breast cancer-specific DFS was 91.0% and OS of 90.8%; univariate analysis indicated that high expression of Ki67 and endocrine therapy or not were the independent risk factors for recurrence and metastasis. Conclusions Segmental mastectomy is of obvious curative effect and certain clinical application value in the treatment of early breat cancer in the elderly.

关 键 词：老年 乳腺癌 早期 区段切除 

分 类 号：R737.9[医药卫生—肿瘤]