Ⅰ、Ⅱ期乳腺癌保乳术与全乳切除术的临床疗效及其影响因素分析  

Analysis of Clinical Efficacy and Influencing Factors of Breast-Conserving Surgery and Mastectomy for StagesⅠandⅡBreast Cancer

作　　者：刘璇 黄凤仪 LIU Xuan;HUANG Fengyi(Department of Breast Surgery,Dongguan Kanghua Hospital,Dongguan 523080,China;Department of Breast Surgery,Dongguan Water Township Central Hospital,Dongguan 523000,China)

机构地区：[1]东莞康华医院乳腺外科,东莞523080 [2]东莞市水乡中心医院乳腺科,东莞523000

出　　处：《中国医药指南》2024年第32期53-56,共4页Guide of China Medicine

摘　　要：目的探究Ⅰ、Ⅱ期乳腺癌保乳术与全乳切除术的临床疗效及其影响因素。方法回顾性分析东莞康华医院2018年1月至2022年12月收治的110例Ⅰ期和Ⅱ期乳腺癌患者的临床资料,其中60例应用全乳切除术治疗,纳入全乳切除组,50例应用保乳术治疗,纳入保乳组。对比两组患者的术后6个月的治疗有效率、疾病控制率、血清癌抗原15-3(CA153)、癌抗原12-5(CA125)和癌胚抗原(CEA)。依据术后6个月的治疗效果将患者分为有效组(77例)和无效组(33例),对比两组的一般资料,多因素Logistic分析影响乳腺癌手术疗效的因素。结果全乳切除组与保乳组患者治疗有效率、疾病控制率比较无差异(P>0.05)。术后3 d,两组的CA153、CA125和CEA水平均低于术前(P<0.05);全乳切除组术后3 d的血清CA153、CA125、CEA水平与保乳组比较无差异(P>0.05)。治疗有效组与无效组在TNM分期、肿瘤大小、术前血清CA153、CA152、CEA水平、淋巴结转移、术后放化疗方面有差异(P<0.05)。以手术疗效为因变量进行Logistic回归分析显示,TNM分期高、肿瘤大、术前血清CA153、CA125、CEA水平升高和淋巴结转移是影响乳腺癌术后疗效的危险因素(P<0.05),而术后放化疗为保护因素(P<0.05)。结论乳腺癌保乳术与全乳切除术均可治疗Ⅰ、Ⅱ期乳腺癌患者,疗效相似,且治疗效果的影响因素包括TNM分期、肿瘤大小、术前肿瘤标志物水平、淋巴结转移、术后放化疗。Objective To explore the clinical efficacy of breast-conserving surgery and mastectomy for stagesⅠandⅡbreast cancer and their influencing factors.Methods A retrospective analysis was conducted on the clinical data of 110 patients with stageⅠandⅡbreast cancer treated at Dongguan Kanghua Hospital from January 2018 to December 2022.Among them,60 cases were treated with mastectomy and were included in the mastectomy group,and 50 cases were treated with breast-conserving surgery and were included in the breast-conserving group.The treatment effectiveness,disease control rate,and serum levels of cancer antigen 15-3(CA153),cancer antigen 12-5(CA125),and carcinoembryonic antigen(CEA)at 6 months postoperatively were compared between the two groups.Patients were divided into an effective group(77 cases)and an ineffective group(33 cases)based on the treatment effects at 6 months postoperatively,and the general data of the two groups were compared.Multivariate Logistic analyses were used to analyze the factors affecting the surgical efficacy of breast cancer.Results There was no difference in treatment effectiveness and disease control rate between the mastectomy group and the breast-conserving group(P>0.05).On the third day after surgery,the levels of CA153,CA125 and CEA in both groups were lower than before surgery(P<0.05).There was no difference in the serum levels of CA153,CA125 and CEA between the total mastectomy group and the breast conservation group three days after surgery(P>0.05).There were differences in TNM staging,tumor size,preoperative serum levels of CA153,CA152,CEA,lymph node metastasis,and postoperative radiochemotherapy between the effective and ineffective groups(P<0.05).Logistic regression analysis with surgical efficacy as the dependent variable showed that higher TNM staging,larger tumor size,elevated preoperative serum levels of CA153,CA125 and CEA,and lymph node metastasis were risk factors affecting the postoperative efficacy of breast cancer(P<0.05),while postoperative radiochemotherapy wa

关 键 词：乳腺癌 乳腺癌保乳术 全乳切除术 疗效 影响因素 

分 类 号：R737.9[医药卫生—肿瘤]