前哨淋巴结活检与保乳手术联合治疗早期乳腺癌的有效性及预后研究

Study on the efficacy and prognosis of sentinel lymph node biopsy combined with breast conserving surgery in the treatment of early breast cancer

梁忠锃 ¹黄胜超 ¹颜泽铭 ¹于淼 ¹陈春燕 ¹张远起¹

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作者信息

1. 广东医科大学附属医院血管甲状腺乳腺外科,广东湛江 524001
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摘要

目的探究前哨淋巴结活检与保乳手术联合治疗早期乳腺癌的有效性及预后情况.方法选取我院2019年1月～2020年12月纳入的60例早期乳腺癌患者,按照随机数字表法分为对照组(n=30)和研究组(n=30).对照组年龄29～73岁,平均(49.58±5.17)岁;肿瘤直径1.1～3.0 cm,平均(1.97±0.10)cm;肿瘤分期:Ⅰ期26例,Ⅱ期4例.研究组年龄30～74岁,平均(50.11±5.03)岁;肿瘤直径1.2～2.9 cm,平均(2.01±0.08)cm;肿瘤分期:Ⅰ期25例,Ⅱ期5例.对照组采用改良根治术联合腋窝淋巴结清扫术治疗,研究组采用前哨淋巴结活检与保乳手术联合治疗.观察和比较两组患者常规临床指标、应激情况、肩关节活动度、乳房美观情况、预后效果、并发症.结果研究组手术时间长于对照组,术中出血量、总引流量、腋窝拔管时间、住院时间均少于对照组(P＜0.05);术前两组PCT、TNF-α、Cor、ACTH水平无明显差异(P＞0.05),术后1 d研究组PCT、TNF-α、Cor、ACTH水平均低于对照组(P＜0.05);术后两组脱发烦恼、治疗副作用评分无明显差异(P＞0.05),术后研究组乳房症状、上肢症状评分低于对照组,体象、性功能、性愉悦、对未来的看法评分高于对照组(P＜0.05);两组转移率、复发率无明显差异(P＞0.05),研究组乳房美观满意度高于对照组(P＜0.05);研究组并发症发生率低于对照组(P＜0.05).结论前哨淋巴结活检与保乳手术联合治疗早期乳腺癌效果满意,可加速患者恢复,降低患者应激反应且具有较好的预后,可提高患者生命质量、乳房美观满意度.

Abstract

Objective To investigate the efficacy and prognosis of sentinel lymph node biopsy combined with breast conserving surgery in the treatment of early breast cancer.Methods 60 patients with early breast cancer admitted from January 2019 to December 2020 in our hospital were selected and divided into control group(n=30)and study group(n=30)according to the random number table method.The age of the control group was 29～73 years old,with an average age of(49.58±5.17)years old;The diameter of the tumor is 1.1～3.0 cm,with an average of(1.97±0.10)cm;Tumor staging:26 cases in stage I and 4 cases in stage II.The age of the study group is 30～74 years old,with an average age of(50.11±5.03)years old;The diameter of the tumor is 1.2～2.9 cm,with an average of(2.01±0.08)cm;Tumor staging:25 cases in stage I and 5 cases in stage II.The control group was treated with modified radical mastectomy combined with axillary lymph node dissection,while the study group was treated with a combination of sentinel lymph node biopsy and breast conserving surgery.The routine clinical indicators,stress levels,shoulder joint activity,breast aesthetics,prognosis and complications were observe and compare between two groups.Results The operation time of the study group was longer than that of the control group,and the intraoperative bleeding volume,total drainage volume,axillary extubation time and hospitalization time were less than those of the control group(P<0.05);There was no significant difference in the levels of PCT,TNF-α,Cor and ACTH between the two groups before operation(P>0.05).The levels of PCT,TNF-α,Cor and ACTH in the study group were lower than those in the control group at 1 day after operation(P<0.05).There was no significant difference in the scores of hair loss distress and treatment side effects between the two groups after surgery(P>0.05).The scores of breast symptoms and upper limb symptoms in the study group were lower than those in the control group after operation.The scores of physical appearance,sexual function,sexual pleasure and future perception in the study group were higher than those in the control group(P<0.05).There was no significant difference in metastasis and recurrence rates between the two groups(P>0.05).The satisfaction with breast aesthetics in the study group was higher than that in the control group(P<0.05).The incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion Sentinel lymph node biopsy combined with breast conserving surgery is effective in the treatment of early breast cancer.It can accelerate the recovery of patients,reduce the stress response of patients,and have a good prognosis.It can improve the quality of life of patients and the satisfaction of breast beauty.

关键词

乳腺癌/早期/前哨淋巴结/活检/保乳手术

Key words

Breast cancer/Early/Sentinel lymph nodes/Biopsy/Breast conserving surgery

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出版年

2024

医师在线

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