超声引导下染色剂标记切缘在早期乳腺癌保乳手术中的应用效果研究  

The roles of ultrasound-guided resection margin marking with dyes in the breast-conserving surgery for early breast cancer

作　　者：张宏旭[1] 刘海旺[2] 胡大为[1] 刘建平[1] 申兴斌[2] 马立辉[1] Hong-xu Zhang;Hai-Wang Liu;Da-wei Hu;Jian-ping Liu;Xing-bin Shen;Li-hui Ma(Department of Breast Surgery,Affiliated Hospital of Chengde Medical University,Chengde,Hebei 067000,China;Department of Pathology,Affiliated Hospital of Chengde Medical University,Chengde,Hebei 067000,China)

机构地区：[1]承德医学院附属医院乳腺外科,河北承德067000 [2]承德医学院附属医院病理科,河北承德067000

出　　处：《中国现代医学杂志》2022年第2期92-96,共5页China Journal of Modern Medicine

基　　金：承德市科技支撑计划(No:201801A032)。

摘　　要：目的探讨超声引导下染色剂标记切缘在早期乳腺癌保乳手术中的应用效果研究。方法选取2016年1月—2018年5月在承德医学院附属医院就诊的临床分期Ⅰ、Ⅱ期乳腺癌患者126例作为研究对象,根据治疗方法不同将其分为对照组和观察组。对照组采用传统手术治疗,观察组在超声引导下应用染色剂标记切缘,借助染色剂浸润性浸润出适当范围,沿着染色组织外切缘切除肿瘤,根据保乳治疗实践指南完整肿瘤切除,并完成3年随访,比较两组术式切缘阳性率,术后生活质量、心理状态、总生存期、无病生存期、术后并发症发生率。结果观察组手术前后精神健康、躯体疾病、生理机能、社会功能及健康状况评分的差值大于对照组(P<0.05)。观察组手术前后SAS、SDS评分的差值大于对照组(P<0.05)。两组术后1年无进展生存率比较,差异无统计意义(P>0.05)。观察组术后3年无进展生存率高于对照组(P<0.05),复发率低于对照组(P<0.05);观察组切缘阴性率低于对照组(P<0.05)。结论超声引导下染色剂标记切缘用于早期乳腺癌保乳手术病理中能提高患者生活质量,改善患者心理状态,且与患者总生存率及无进展生存率有关。Objective To investigate the roles of ultrasound-guided resection margin marking with dyes in the breast-conserving surgery for early breast cancer.Methods A total of 126 patients with stageⅠandⅡbreast cancer treated in our hospital from January 2016 to May 2018 were selected and divided into control group and observation group.The control group was treated with conventional surgery,while the surgery in the observation group was facilitated by ultrasound-guided resection margin marking with dyes in advance.Complete tumor resections were performed according to the guidelines for breast-conserving surgery and the patients were followed up for 3 years.The rate of positive surgical margin,postoperative quality of life,mental health status,overall survival,disease-free survival,and the incidence of postoperative complications between the two groups were compared.Results The differences in scores of mental health,bodily pain,physical functioning,social functioning and general health before and after operation in the observation group were greater than those in the control group(P<0.05).Besides,the differences in Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores before and after operation in the observation group were also greater than those in the control group(P<0.05).The 1-year progression-free survival rate was not different between the groups(P>0.05).However,the 3-year progression-free survival rate was higher,and the recurrence rate was lower in the observation group compared with the control group(P<0.05).In addition,the rate of negative margins in the observation group was higher than that in the control group(P<0.05).Conclusions The breast-conserving surgery for early breast cancer,facilitated by ultrasound-guided resection margin marking with dyes,improves the quality of life and the mental health status of patients,and affects the overall survival rate and progression-free survival rate.

关 键 词：乳腺癌 保乳手术 超声引导 染色剂标记切缘 生存质量 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]