早期乳腺癌保乳术中切缘钟点法与垂直切缘切取法取材的可行性对比  

Comparison of Feasibility of Cutting Edge Clock Method and Vertical Cutting Edge Method in Breast-conserving Surgery for Early Breast Cancer

作　　者：乐桂花[1] 伍毓强[1] 邓晓玲 LE Guihua;WU Yuqiang;DENG Xiaoling(Sanming Second Hospital,Yong’an 366000,China;不详)

机构地区：[1]三明市第二医院,福建永安366000

出　　处：《中外医学研究》2022年第32期64-68,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨早期乳腺癌保乳术中切缘组织冰冻切片病理检查应用钟点法取材与垂直切缘切取法取材的临床效果。方法:回顾性分析2017年1月-2019年1月于三明市第二医院接受早期乳腺癌保乳术120例患者的病历资料,根据切缘术中冰冻取材方法,将采取钟点法取材的设为钟点法组(n=62),垂直切缘切取法的设为对照组(n=58)。术后持续随访患者,随访时间截至2022年4月。比较两组手术情况(手术时间、术中出血量、平均引流量)、切缘情况(术中首次冰冻切片病理学阴性率、平均切缘距离、术后石蜡切片间接切缘病理学阴性率、术中首次冰冻切片病理学假阴性率),随访分析两组再次手术率、无病生存期(DFS)、3年局部区域复发率(LRR)。结果:钟点法组手术时间长于对照组,平均切缘距离小于对照组,差异均有统计学意义(P<0.05);钟点法组术中出血量、术中首次冰冻切片病理学阴性率、术后石蜡切片间接切缘病理学阴性率均大于对照组,平均引流量少于对照组,但差异均无统计学意义(P>0.05);钟点法组术中首次冰冻切片病理学假阴性率大于对照组,但差异无统计学意义(P>0.05);术后两组DFS、3年LRR、再次手术率比较,差异均无统计学意义(P>0.05)。结论:早期乳腺癌保乳术中切缘钟点法取材无法有效降低切缘假阴性率,与垂直切缘切取法相比增加手术操作时间,缩小切缘距离,但并不能改善预后,临床做切缘取材方法选择时仍需谨慎。Objective:To explore the clinical effect of frozen section pathological examination of cut margin tissue in breast-conserving surgery for early breast cancer by using clock method and vertical cutting edge method.Method:The data of 120 cases of early breast cancer who underwent breast-conserving surgery in Sanming Second Hospital from January 2017 to January 2019 were retrospectively analyzed.According to the method of intraoperative frozen sampling of surgical margins,those who took the clock method sampling method were set as the clock method group (n=62),and those who took the vertical cutting edge method sampling were set as the control group (n=58).Patients were followed up until April 2022.The operation conditions (operation time,intraoperative blood loss,mean drainage volume),surgical margins (pathological negative rate of the first frozen section during operation,mean surgical margin distance,pathological negative rate of indirect paraffin section after operation,and false negative rate of the first frozen section during operation) of two groups were compared,the reoperation rate,disease-free survival (DFS) and 3-year local regional recurrence rate (LRR) of two groups were followed up and analyzed.Result:The operation time of the clock method group was longer than that of the control group,and the average margin distance was smaller than that of the control group,and the differences were statistically significant (P<0.05).The intraoperative blood loss,pathological negative rate of the first frozen section and pathological negative rate of the indirect margin of paraffin section after operation in the clock method group were higher than those in the control group,and the average drainage volume was lower than that in the control group,and the differences were not statistically significant (P>0.05).The false negative rate of the first frozen section pathology in the clock method group was higher than that in the control group,but the difference was not statistically significant (P>0.05).There were no signif

关 键 词：乳腺癌 保乳术 切缘取材 假阴性率 

分 类 号：R737.9[医药卫生—肿瘤]