乳腺癌保乳手术切缘阳性相关因素分析

Correlative factors of positive margin in breast conservation

目的:探讨与保乳手术切缘阳性的相关因素。方法:免疫组化S-P法检测保乳手术切缘阳性组和切缘阴性组患者乳腺原发癌C-erbB-2、P53、PCNA蛋白表达情况,分析该3项指标及各临床病理因素与切缘状况的关系。结果:切缘阳性与患者年轻(≤35岁)、乳腺原发癌组织学分级高、伴有广泛的导管内癌成分(EIC)及C-erbB-2(+)有关(P<0.05)。结论:在行保乳手术时,术中应详细检查切缘状况,特别是对乳腺原发癌EIC(+)或C-erbB-2扩增者,以确保获得阴性切缘,否则宜行全乳切除。

Objective: To explore the correlative factors of positive margin in breast conservation. Methods: Immunohistochemical S-P method was applied to detect expressions of C-erbB-2,P53 and PCNA of primary tumors in positive and negative margin groups of breast conservation. The relationships between expressions of the three indexes as well as other clincopatholgic characteristics and margin status were analyzed. Results: Positive margin was related with younger age(≤35;,higher nuclear grade, extensive inductal component(EIC; and C-erbB-2(+;in primary tumor(P<0.05;. Conclusion: The margins should be examined carefully during breast conservative surgery so as to achieve negative margin, especially when primary tumor with EIC or C-erbB-2(+;, or else, mastectomy should be done.