保乳术治疗乳腺癌的中远期效果及术后复发因素分析  

Analysis on the Medium and Long-term Effect of Breast Cancer

作　　者：李海平[1] 李江涛[1] 刘薇[1] LI Haiping;LI Jiangtao;LIU Wei(Zhengzhou People's Hospital,Zhengzhou,450000)

机构地区：[1]河南省郑州人民医院,450000

出　　处：《实用癌症杂志》2022年第8期1356-1358,1366,共4页The Practical Journal of Cancer

摘　　要：目的探究保乳术治疗乳腺癌的中远期效果及术后复发因素。方法选择乳腺癌患者180例,依据手术方式不同分为保乳组54例及传统组126例。保乳组采用保乳术治疗,传统组行改良根治术。比较2组围术期情况、复发率、3年生存率及5年生存率。分析保乳组术后复发的相关因素(依据病灶是否复发分为复发组及未复发组)。结果保乳组手术时间、引流时间、住院时间均短于传统组,术中出血量、引流量均少于传统组,差异有统计学意义(P<0.05)。2组复发率、3年生存率及5年生存率比较,差异无统计学意义(P>0.05)。保乳组术后复发组年龄<40岁、有淋巴结转移、TNM分期Ⅱ期、Her-2阳性型发生率均高于未复发组,差异有统计学意义(P<0.05);年龄、淋巴结转移、TNM分期、分子分型是影响保乳组术后复发的独立危险因素(OR值≥1,且P<0.05)。结论保乳术治疗乳腺癌对患者造成的创伤小、中远期效果好、疗效确切,患者住院时间短,但对年龄<40岁、伴有淋巴结转移、TNM分期Ⅱ期且Her-2阳性型患者需慎用保乳术,以降低术后复发风险。Objective To explore the long-term effect of breast-conserving surgery in the treatment of breast cancer and postoperative recurrence factors.Methods 180 patients with breast cancer were selected and divided into the breast-conserving group(n=54)and the traditional group(n=126)according to different surgical methods.The breast-conserving group was treated with breast-conserving surgery,while the traditional group was treated with modified radical mastectomy.The perioperative situation,recurrence rate,3-year survival rate and 5-year survival rate of the 2 groups were compared.Factors related to postoperative recurrence in the breast-conserving group were analyzed(the recurrence group and non-recurrence group were divided according to whether the lesions recurred).Results The operation time,drainage time and hospital stay of the breast-conserving group were shorter than those of the traditional group,and the intraoperative blood loss and drainage volume were less than those of the traditional group,with statistical significance(P<0.05).There were no significant differences in recurrence rate,3-year survival rate and 5-year survival rate between the 2 groups(P>0.05).In the breast-conserving group,the recurrence group was less than 40 years old,had lymph node metastasis,TNM stageⅱand the incidence of HER-2 positive type were higher than those in the non-recurrence group,the differences were statistically significant(P<0.05).Age,lymph node metastasis,TNM stage and molecular type were independent risk factors for postoperative recurrence in the breast-conserving group(OR value≥1,P<0.05).Conclusion Breast-conserving surgery for breast cancer has less trauma,good long-term effect,definite efficacy and short hospital stay.However,it should be used cautiously for patients under 40 years old,accompanied by lymph node metastasis,TNM stageⅱand HER-2 positive type to reduce postoperative recurrence rate.

关 键 词：乳腺癌 保乳手术 中远期效果 复发 影响因素 

分 类 号：R737.9[医药卫生—肿瘤]