摘要
目的:分析保乳手术切缘阳性率及影响因素,探讨采用彩超引导切除病灶及周边1 cm组织范围的可行性。方法:2013-04~2018-02期间,本单位进行保乳手术的病例为研究对象,彩超引导切除病灶及周边1cm组织,采用墨汁染色法检查切缘情况,回顾分析病灶切缘阳性率及其影响因素。结果:共89例保乳手术纳入研究,平均年龄42.41岁,病灶切缘阳性率为15.7%(14/89例),浸润性癌较导管内癌和浸润性癌伴导管内癌的切缘阳性率低(7.3%vs 22.9%,P=0.044),组织学高级别较低、中级别切缘阳性率高(63.6%vs 9.0%,P<0.001);切缘阳性与年龄、病灶大小、肿块是否可触及、是否合并可疑恶性钙化、病灶边界、新辅助化疗、淋巴结转移、雌激素受体状况等无关。结论:保乳术中应用彩超引导确定病灶周边1 cm切除范围是可行的,但对于组织学高级别、穿刺病理为导管内癌或浸润性癌伴导管内癌病例,可适当增加切除范围。
Objective : To analyze the surgical margin positive rate of breast-conserving surgery(BCS) and its influencing factors, and to explore the feasibility of ultrasound guidance resection of thelesion and surrounding 1 cm tissue. M ethods: From April 2.13 to February 2.18,the patientsreceived BCS in the university of HongKong Shenzhen hospital were recruited, ultrasound guidance resectionof lesion and surrounding 1 cm tissue, positive margin defined as ink on invasive carcinoma orductal carcinoma in situ ( DC IS ) ,positive margin rate and its influencing factors were reviewed.Results:A total of 89 cases included in this study,average age was 42.41 years,the positive rate was 15.7% (14/89) ,the positive margin rate of invasive carcinoma was lower than DCISand invasive carcinoma combined with DC IS (7.3% VS 22.9% ,P = 4.444) ,the positive margin rate ofhigh grade tumor was higher than low grade and middle grade (63.6% VS 9 . % ,_P〈4.041). The age,lesion size,palpation,mass with suspicious calcification,lesions border,neoadjuvant chemotherapy,lymph node metastasis and estrogen receptor did not affected with margin positive . Conclusion;Ultrasoundguidance resection of the lesion and surrounding 1 cm tissue in BCS was feasible, but the histo-logical high grade tumor, DCIS and invasive carcinoma combined with DCIS should be increased resec-tion surrounding tissue.
作者
郑爱秋
魏建南
杨勇
石剑
王媛
王敏
周颉
许晓华
ZHENG Ai-qiu;WEI Jian-nan;YANGYong(The University o f Hong Kong Shenzhen Hospital,Shenzhen 518453 China')
出处
《内蒙古医科大学学报》
2018年第4期324-328,共5页
Journal of Inner Mongolia Medical University
基金
广东省医学科学技术研究基金项目(B2016137)
关键词
乳腺癌
保乳手术
切缘
彩超
breast cancer
breast -conserving surgery
surgical margin
ultrasound