整形保乳手术在年轻早期乳腺癌患者中的临床疗效及对血CD19^+B细胞、NK细胞和IL-6水平的影响  

Clinical curative effect of orthopedic breast-conserving surgery in young early breast cancer and its effect on blood CD19^+B lymphocyte,NK and IL-6 levels

作　　者：刁岩[1] 单昌友 赵阳[1] 管海涛[1] 靳耀锋[2] 王子明[3] 张淑群[1] DIAO Yan~;SHAN Chang-you~;ZHAO Yang~;GUAN Hai-tao;JIN Yao-feng;WANG Zi-ming;ZHANG Shu-qun(Department of Oncology,Second Affiliated Hospital of Xi＇an Jiaotong University,Shaanxi Xi＇an 710004,China;Department of Pathology,Second Affiliated Hospital of Xi＇an Jiaotong University,Shaanxi Xi＇an 710004,China;Department of Urology,Second Affiliated Hospital of Xi ＂an Jiaotong University,Shaanxi Xi＇an 710004,China)

机构地区：[1]西安交通大学第二附属医院肿瘤科,陕西西安710004 [2]西安交通大学第二附属医院病理科,陕西西安710004 [3]西安交通大学第二附属医院泌尿外科,陕西西安710004

出　　处：《中国医刊》2018年第11期1244-1248,共5页Chinese Journal of Medicine

基　　金：陕西省重点研发计划(2017SF-250)

摘　　要：目的探讨整形保乳手术在年轻早期乳腺癌患者中的临床效果及对外周血CD19^+B细胞、自然杀伤(naturalkiller,NK)细胞和白细胞介素6(interleukin-6,IL-6)水平的影响。方法选取2016年1月至2017年12月于本院治疗的早期乳腺癌患者90例,根据手术方案分为对照组(n=45例)和观察组(n=45例),所有患者均未行术前化疗。对照组采用常规保乳手术治疗,观察组采用整形保乳手术治疗,术后对患者进行5年随访,对手术效果进行评估。记录并统计两组术中出血量、手术及住院时间、切除组织重量、最小手术切缘及最大手术切缘;采用流式细胞仪测定两组手术前后的CD19^+B细胞、NK细胞水平;采用酶联免疫吸附试验测定两组手术后IL-6水平;记录并统计两组术后血清肿、血肿、切口开裂、脂肪坏死及皮肤退缩的发生率,比较两组的临床疗效及对血CD19^+B细胞、NK细胞及IL-6水平的影响。结果观察组的手术时间、切除组织重量、最小手术切缘及最大手术切缘均大于对照组(P<0.05),而术中出血量、住院时间均小于对照组(P<0.05);两组术后血CD19^+B细胞、NK细胞及IL-6水平均低于手术前(P<0.05),观察组手术后血CD19^+B细胞、NK细胞及IL-6水平均低于对照组(P<0.05);观察组术后血清肿、血肿、切口开裂、脂肪坏死及皮肤退缩的发生率与对照组比较差异无显著性(P>0.05)。结论整形保乳手术用于年轻早期乳腺癌患者不仅能保证保乳手术切缘安全性,还能降低血CD19^+B细胞、NK细胞及IL-6水平,值得推广应用。Objective To investigate the clinical effects of orthopedic breast-conserving surgery in young early-stage breast cancer patients and their effects on blood CD19^＋B lymphocyte, NK and IL-6 levels. Method A total of 90 patients with early breast cancer admitted to hospital from January 2016 to December 2017 were selected and divided into a control group（n=45） and an observation group（n=45） according to the surgical plan. The control group was treated with conventional breast-conserving surgery. The observation group was treated with plastic breast-conserving surgery. The patients were followed for 5 years after operation and the surgical outcome was evaluated. Two groups of intraoperative blood loss, surgery and length of stay, weight of the resection tissue, minimum surgical margin, and maximum surgical margin were recorded and counted; flow cytometry was used to determine CD19^＋B lymphocyte and natural killer（NK） levels before and after surgery in both groups. The enzyme-linked immunosorbent assay was used to measure the interleukin-6（IL-6） levels after surgery; the incidence of seroma, hematoma, incision, fat necrosis, and skin retraction was recorded and compared between the two groups. Clinical efficacy and effects on blood CD19^＋B lymphocyte, NK and IL-6 levels. Result The operative time, resection tissue weight, minimum surgical margin, and maximum surgical margin in the observation group were all greater than those in the control group（P〈0.05）. The intraoperative blood loss and length of stay in the observation group were all shorter than those in the control group（P〈0.05）. The blood levels of CD19^＋B lymphocyte, NK and IL-6 were lower in the observation group and the control group than before the operation（P〈0.05）. The levels of blood CD19^＋B lymphocyte, NK and IL-6 in the observation group were lower than those in the control group after surgery（P〈0.05）; there was no significant difference in postoperative serum edema, hematoma, incision cracking, fat nec

关 键 词：整形保乳手术 手术切缘 CD19^+B细胞 自然杀伤细胞 白细胞介素-6 

分 类 号：R605[医药卫生—外科学]