乳腺癌术中保留肋间臂神经的可行性病理学观察

Feasibility study of preserving intercostobrachial nerve during dissection for breast carcinoma： evidences from a preliminary pathologic exploration Feasibility study of preserving intercostobrachial nerve during dissection for breast carcinoma： evidences from a preliminary pathologic exploration

目的 探讨乳腺癌术中保留肋间臂神经（ICBN）的可行性.方法 选取华北煤炭医学院附属医院肿瘤外科2004年6月至2006年6月间99例（其中包括15例保留ICBN失败者）手术切除的ICBN及周围组织,采用HE染色方法,观察切除的神经及周围组织的病理变化.结果 99例手术切除的ICBN中96例（96.97%）在镜下观察可见神经细胞完整未受侵犯,神经周围组织中未见癌组织浸润.28例伴腋窝淋巴结肿大患者中,3例（10.71%）与神经紧邻的脉管内可见到癌栓存在.结论 病理学观察结果表明,乳腺癌术中保留ICBN具有可行性.应该提倡并大力推广保留ICBN的乳腺癌手术.

Objective To determine the feasibility of preservation of intercostobrachial nerve （ICBN） in breast cancer. Methods During June 2004 to June 2006, 99 patients with operable breast cancer receiving an axillary lymph node dissection at our department were analyzed. The extirpated ICBN and ambient tissues were tested by HE staining to observe the pathological changes. Results In 96（96. 97% ） cases with ICBN sacrificing, the nerves were not violated microscopically and the nerve cells remained intact. Of 28 patients with axillary lymphadenectasis, only 3 cases （10.71%） were found to have tumor emboli in the peri-neural vessels. Conclusion The preservation of ICBN is a feasible and safe technique. The operative approach should be advocated. If at all possible, a surgeon should identify ICBN and preserve it.