保留乳头乳晕复合体的乳腺癌改良根治术预后的相关因素分析  

Correlation analysis of prognostic factors in modified radical mastectomy for breast cancer with preserved papillary areola complex

作　　者：李福平 王茂[1] 刘超[1,2] 李宏 宫小勇[1] 周志辉[1] 李媛媛 代引海[1] Li Fuping;Wang Mao;Liu Chao;Li Hong;Gong Xiaoyong;Zhou Zhihui;Li Yuanyuan;Dai Yinhai(Department of breast cancer,the second affiliated hospital of shaanxi university of traditional Chinese medicine,XianYang 712000;Liaoyang central hospital two general department,Liaoyang 111000)

机构地区：[1]陕西中医药大学第二附属医院肿瘤乳腺科,陕西咸阳712000 [2]辽阳市中心医院普外二科,辽宁辽阳111000

出　　处：《中华普外科手术学杂志（电子版）》2020年第6期608-611,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：辽宁省科学技术厅重点研发计划(2016JM137);陕西中医药大学学科创新团队项目(2019-SY03)。

摘　　要：目的探究影响保留乳头乳晕复合体(NAC)的乳腺癌改良根治术(NSM)预后的相关因素。方法回顾性分析2011年1月至2014年12月84例早期原发性乳腺癌并接受NAC的NSM患者临床病理资料。使用统计软件SPSS 20.0进行数据分析,采用K-M生存曲线评估术后无病生存(DFS)及总生存(OS),采用单因素分析和Cox多因素分析影响NSM术后患者DFS和OPS的影响因素。P<0.05差异有统计学意义。结果术后局部复发8例,远处转移6例,术后5年DFS为83.3%,OS为91.7%。多因素分析显示,肿瘤最大径、肿瘤距乳头乳晕距离(TND)、腋窝淋巴结状态、组织学类型及Her-2阳性是影响DFS的独立危险因素(P<0.05);而腋窝淋巴结状态是影响术后OS的独立危险因素(P<0.05)。结论肿瘤最大径、TND、腋窝淋巴结状态、组织学类型及Her-2阳性是DFS的独立危险因素,腋窝淋巴结状态是OS的独立危险因素;腋窝淋巴结情况同时影响患者术后DFS和OS,术前系统、精准地评估并妥善处理特殊腋窝淋巴结可提高乳腺癌患者预后。Objective To explore the factors influencing the prognosis of modified radical mastectomy(NSM)for breast cancer with preserved papillary areola complex.Methods A retrospective analysis was performed on the clinicopathological data of 84 patients with early primary breast cancer who underwent NAC retention modified radical mastectomy from January 2011 to December 2014.Postoperative recurrence and metastasis were observed,data entry was analyzed using statistical software SPSS 20.0,and postoperative disease-free survival(DFS)and overall survival(OS)were evaluated using K-M survival curve.K-M univariate analysis and Cox multivariate analysis were used to explore the influencing factors on DFS and OPS of patients after NSM surgery.Results Postoperative local recurrence was found in 8 cases and distant metastasis in 6 cases.The 5-year survival curve of K-M was 83.3%for DFS and 91.7%for OS.Multivariate analysis showed that maximum tumor diameter,tumor distance from the nipple and areola(TND),axillary lymph node status,histological type and positive Her-2 were independent risk factors affecting DFS(P<0.05);Axillary lymph node status was an independent risk factor for postoperative OS(P<0.05).Conclusion Maximum tumor diameter,TND,axillary lymph node status,histological type and positive Her-2 were independent risk factors for DFS,while axillary lymph node status was an independent risk factor for OS.The status of axillary lymph nodes affects both postoperative DFS and OS,and preoperative systematic,accurate evaluation and proper treatment of special axillary lymph nodes can improve the prognosis of breast cancer patients.

关 键 词：乳腺肿瘤 乳房切除术 改良根治性 预后 乳头乳晕复合体 

分 类 号：R73[医药卫生—肿瘤]