【摘要】：目的：探討早期實施Mammotome旋切術(shù)后的乳腺癌患者的預(yù)后相關(guān)因素及影響其術(shù)后切緣情況的因素,以期為Mammotome在乳腺癌患者的臨床應(yīng)用提供參考。材料與方法：本文回顧性分析2004年1月1日至2014年10月廣西腫瘤醫(yī)院263例早期實施Mammotome旋切術(shù)的乳腺癌患者的臨床資料。結(jié)果：263例患者M(jìn)ammotome旋切術(shù)后行根治性手術(shù)者257例。術(shù)后病理提示切緣陰性率為18.99%(49/257)；陽性率為81.01%(206/257)。病灶直徑≤1.5cm(組1)的切緣陰性率為51.2%(21/41),1.5cm且≤2.5cm(組2)的為25.7%(18/70),2.5cm且-≤3cm的(組3)為6.5%(3/46),3cm(組4)的為7%(7/100)。四組陰性率的差異具有統(tǒng)計學(xué)意義(P=0.000)。各組兩兩陰性率比較提示：除組3與組4無統(tǒng)計學(xué)差異外(P=0.915),各組間的切緣陰性率的兩兩比較均有明顯的統(tǒng)計學(xué)差異。脈管癌栓組及無脈管癌栓組的切緣陰性率的差異有統(tǒng)計學(xué)意義(P=0.014)。淋巴結(jié)轉(zhuǎn)移組的與無轉(zhuǎn)移組的切緣陰性率的差異有統(tǒng)計學(xué)意義(P=0.000)。生存曲線圖顯示切緣陽性與陰性兩者曲線有交叉,提示兩組PFS無統(tǒng)計學(xué)差異(P=0.443)。手術(shù)組與非手術(shù)組的PFS有統(tǒng)計學(xué)差異(P=0.000)。放療組與非放療組(P=0.341)、化療組與非化療組(P=0.647)、二次手術(shù)間隔時間≥14天、14天且7天,≤7天的PFS均無統(tǒng)計學(xué)意義(P=0.236)。單因素分析顯示：病灶大小情況(P=0.000)、病理提示淋巴結(jié)轉(zhuǎn)移(P=0.002),脈管癌栓(P=0.004),人表皮生長因子受體-2(P=-0.000)是影響Mammotome術(shù)后乳腺癌患者預(yù)后的危險因素。Cox多因素分析提示淋巴結(jié)轉(zhuǎn)移、人表皮生長因子受體-2是影響Mammotome術(shù)后乳腺癌患者的獨立危險因素。結(jié)論：1、病灶直徑≤1.5cm的乳腺癌患者M(jìn)ammotome術(shù)后切緣陰性率最高,但仍遠(yuǎn)遠(yuǎn)小于保乳手術(shù)的切緣陰性率。2、Mammotome術(shù)后切緣陽性組及陰性組患者,若術(shù)后行二次手術(shù),兩者的PFS無明顯的差異。3、Mammotome術(shù)后切緣陽性可能不是Mammotome術(shù)后患者化療或放療的臨床指征。4、影響Mammotome術(shù)后浸潤性乳腺癌患者預(yù)后的獨立因素可能包括淋巴結(jié)轉(zhuǎn)移、HER-2,不包括切緣陽性。
[Abstract]:Objective: to investigate the prognostic factors of breast cancer patients after early Mammotome resection and the factors affecting the postoperative margin of breast cancer, so as to provide reference for the clinical application of Mammotome in patients with breast cancer. Materials and methods: the clinical data of 263 patients with breast cancer undergoing early Mammotome resection in Guangxi Cancer Hospital from January 1, 2004 to October 2014 were analyzed retrospectively. Results: radical operation was performed in 257 patients after Mammotome resection. Postoperative pathology showed that the negative rate of incised margin was 18.99% (49 鈮，

本文編號：2485076