影响乳腺癌患者保乳手术边缘阳性因素的临床研究

Factors associated with positive surgical margins in breast conserving surgery for breast cancer

目的探讨乳腺癌的临床病理学特征对保乳手术边缘阳性的影响。方法189例预行保乳手术术(BCT)的原发性乳腺癌患者,分析她们的临床特征(年龄,活检类型)和病理学特征(肿瘤大小,组织学类型,激素受体状态,HER2状态,和腋窝淋巴结状态)与阳性手术边缘的关系。结果189例患者中本组室心针肿脾物案例活检确诊79例,门诊或手术中切除活检确诊128例。61例手术边缘阳性(32.3%)。结论本研究的结果揭示:肿瘤直径大于2cm,腋窝淋巴结阳性PR阳性和年龄小于50岁是乳癌保乳手术边缘阳性的高危因素对1999年1月～2004年7月189例乳腺癌患者按受保乳手术进行回顾性分析,并总结手术切口边保阳性与临床特征病理案组但表现及激素受体状态的关系。

Objective To investigate the climical pathological feature of breast cancer for influencing the positive margins of breat conserving surgery. Methods From January 1999 to July 2004,189 cases with breast cancer received preparing breast conserving surgery were analyzed retrospectively, and relatiohship between the positive margins and clincal teature, pathological type and hormone receptor status, were summarized. Results In this group the diagnosis was confirmed by core needle biopsy in 79 cases and. by resecteing in 128 cases. positive margims were 61 eases （32.3%） in all eases. Conclusion The results of this research suggest that the high risk of breast consevving surgery are tumar diameter more tham 2 cm, axillary lymph node positive, progestogen receptor positive and age less tham 50 years.