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乳腺癌改良根治术对患者免疫功能、甲状腺激素及预后的影响

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目的 探讨乳腺癌改良根治术对患者免疫功能、甲状腺激素及预后的影响。方法 选取 2019 年 5 月至 2022 年5 月琼海市人民医院进行临床研究及随访的乳腺癌患者 153 例,按照治疗方式的不同分为对照组 65 例和研究组 88 例,对照组采用传统乳腺癌根治术治疗,研究组采用乳腺癌改良根治术治疗,比较 2 组围手术期相关指标,术前及术后 1 个月的免疫功能、甲状腺激素变化,并发症发生情况,以及随访 1 年后的预后情况。结果 围手术期研究组患者与对照组比较,手术时间、住院时间较短(P<0。05),术中出血量较少(P<0。05)。与术前比较,术后 1 个月研究组与对照组患者CD4+ T淋巴细胞、CD4+/CD8+比值、自然杀伤(natural killer,NK)细胞水平降低(P<0。05),CD8+ T淋巴细胞水平升高(P<0。05)。术后 1 个月,与对照组患者比较,研究组CD4+ T淋巴细胞、NK细胞水平、CD4+/CD8+比值较低(P<0。05),CD8+ T淋巴细胞水平较高(P<0。05)。与术前比较,术后 1 个月,研究组与对照组患者三碘甲状腺原氨酸(triiodothyronine,T3)、甲状腺素(thyroxine,T4)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)水平降低(P<0。05),促甲状腺激素(thyroid stimulating hormone,TSH)水平升高(P<0。05)。术后 1 个月与对照组患者比较,研究组T3、T4、FT3、FT4 水平较低(P<0。05),TSH水平较高(P<0。05)。与对照组患者比较,研究组并发症发生率、局部复发率、腋淋巴结复发率、远处转移率均较低(P<0。05),生存率较高(P<0。05)。结论 乳腺癌改良根治术可有效缩短手术时间、住院时间,减少术中出血量,改善乳腺癌患者的免疫功能、甲状腺激素水平,降低并发症,提高患者预后生存情况。
Effects of modified radical mastectomy on immune function,thyroid hormone and prognosis of patients with breast cancer
Objective To investigate the effects of modified radical mastectomy on the immune function,thyroid hormone and prognosis of patients with breast cancer.Methods From May 2019 to May 2022,153 patients with breast cancer who were clinically studied and followed up in the Qionghai People's Hospital were selected in this study.They were divided into control group(n=65)and study group(n=88).Traditional and modified radical mastectomies were applied in the control group and study group,respectively.Perioperative related indicators,immune function and thyroid hormones before surgery and one month after surgery,complications and prognosis within one year after surgery were compared between the two groups.Results The study group had shorter operating time and hospitalization time and less intraoperative bleeding than the control group(P<0.05).Compared to before surgery,CD4+ T,CD4+/CD8+,natural killer(NK)cells in both groups were significantly decreased one month after surgery(P<0.05),while CD8+ T cells were significantly increased(P<0.05).The CD4+ T,CD4+/CD8+ and NK cell levels in the study group were significantly lower than those in the control group(P<0.05),while CD8+ T cell level in the study group was significantly higher than that in the control group(P<0.05).Compared to before surgery,triiodothyronine(T3),thyroxine(T4),free triiodothyronine(FT3)and free thyroxine(FT4)in both groups were significantly decreased one month after surgery(P<0.05),while thyroid stimulating hormone(TSH)was significantly increased(P<0.05).The levels of T3,T4,FT3 and FT4 in the study group were significantly lower than those in the control group(P<0.05),while TSH in the study group was significantly higher than that in the control group(P<0.05).The study group had lower incidence of complications,local recurrence rate,axillary lymph node recurrence rate,and distant metastasis rate and higher survival rate than the control group(P<0.05).Conclusion Modified radical mastectomy can effectively shorten the operation time and hospital stay,decrease intraoperative bleeding,improve the immune function and thyroid hormone levels,reduce complications,and improve the prognosis and survival of patients with breast cancer.

Modified radical mastectomyImmune functionThyroid hormonePrognosis

唐仁梅、陈锋夏、王健宝、邱庆文

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571400 海南 琼海,琼海市人民医院乳腺甲状腺外科

海南省人民医院(海南医学院附属海南医院)胸外科

乳腺癌改良根治术 免疫功能 甲状腺激素 预后

海南省重点研发计划项目

ZDYF2017090

2024

海军医学杂志
海军医学研究所

海军医学杂志

CSTPCD
影响因子:0.518
ISSN:1009-0754
年,卷(期):2024.45(2)
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