乳腺癌患者手术创面冲洗液细胞学检查的价值

Washing liquid cytology examination of operative wound in patients with breast tumor

目的 观察乳腺癌患者手术创面脱落癌细胞与临床病理分期的关系 ,为术中采用杀灭脱落癌细胞的措施提供依据。 方法 对 2 6 2例乳腺癌患者手术创面冲洗液进行细胞学检查 ,并将结果与临床病理分期做对比分析。 结果 本组患者脱落癌细胞阳性者 6 3例 ,占 2 4%。Ⅰ、Ⅱ、Ⅲ、Ⅳ期乳腺癌患者脱落癌细胞检出率分别为 5 3%、2 7 1%、79 3%、10 0 %。T1、T2 和T3 以上者 ,脱落癌细胞检出率分别为 6 1%、18 9%、5 1 3%。腋淋巴结转移数目超过 3枚者 ,脱落癌细胞阳性率为5 8 6 % ;而转移数目≤ 3个和无腋淋巴结转移者 ,阳性率分别为 14 3%、14 1%。 结论 乳腺癌患者手术创面脱落癌细胞检出率随着肿瘤增大、病期进展、淋巴结转移数目的增多而增加 ,术中创面采用杀灭脱落癌细胞的措施是必要的。

Objectives[WT5”BZ] To study the relation between exfoliated tumor cells in operative wound and clinical pathologic classification and to provide theory for killing exfoliated tumor cells in operation. [WT5”HZ]Method[WT5”BZ] Washing liquid cytology examination of the operative wound was done in 262 patients with breast tumor.The relation between cytology examination and pathological classification was analyzed. [WT5”HZ]Results[WT5”BZ] In the 262 patients, exfoliated tumor cells were found in 63 patients, (24%). The detection rate in patients with Ⅰ,Ⅱ,Ⅲ and Ⅳ stage was 5 3%, 27 1%,79 3% and 100% respectively; The rate for T 1, T 2, T 3 stage was 6 1%, 18 9% and 51 3% respectively. The detection rate was 58 6% when the number of metastasis lymph node beyond 3;the rate was 14 3% and 14 1% respectively when the number below 3 or no lymphmetastasis. [WT5”HZ]Conclusion[WT5”BZ] The detection rate of exfoliated tumor cells is related to tumor advance, and it is necessary to kill exfoliated tumor cells in operation. [WT5”HZ]