单切口环乳晕入路行保留乳头乳晕乳腺癌改良根治术联合即刻乳房再造对乳腺癌患者美学效果、应激反应指标及外泌体miRNA表达量的影响

Effects of modified radical mastectomy with nipple areola preservation through single incision ring areola approach and immediate breast reconstruction on aesthetic effect,stress response indexes and expression quantity of exosome miRNA in patients with breast cancer

目的探讨单切口环乳晕入路行保留乳头乳晕乳腺癌改良根治术联合即刻乳房再造对乳腺癌患者美学效果、应激反应指标及外泌体miRNA表达量的影响。方法回顾性选取2019年1月至2021年1月本院收治的乳腺癌患者60例,依据手术方法将其分为单切口组和双切口组,各30例。比较两组的治疗效果。结果单切口组患者的手术时间、住院时间均短于双切口组(P<0.05)。单切口组患者的乳头乳晕区感觉、双乳对称性、整体美学效果评分均高于双切口组(P<0.05)。手术后,两组的SOD、NO水平及miR-27a相对表达量均降低,Cor水平均升高,且单切口组的SOD、NO水平均高于双切口组,Cor水平及miR-27a相对表达量均低于双切口组(P<0.05)。单切口组患者的术后并发症总发生率为3.33%,低于双切口组的20.00%(P<0.05)。结论与双切口经乳腺和腋窝入路相比,单切口环乳晕入路行保留乳头乳晕乳腺癌改良根治术联合即刻乳房再造的美学效果更好,能有效地减轻患者的应激反应,降低外泌体miRNA表达水平。

Objective To investigate the effects of modified radical mastectomy with nipple areola preservation through single incision ring areola approach and immediate breast reconstruction on aesthetic effect,stress response indexes and expression quantity of exosome miRNA in patients with breast cancer.Methods A total of 60 patients with breast cancer admitted in our hospital from January 2019 to January 2021 were selected retrospectively and divided into single incision group and double incision group according to surgical methods,with 30 cases in each group.The therapeutic effect of the two groups was compared.Results The operation time and hospital stay of the single incision group were shorter than those of the double incision group(P<0.05).The scores of nipple areola sensation,bilateral breast symmetry and overall aesthetic effect in the single incision group were higher than those in the double incision group(P<0.05).After operation,the levels of SOD,NO and the relative expression quantity of miR-27a in the two groups decreased,while the level of Cor increased,and the levels of SOD and NO in the single incision group were higher than those in the double incision group,and the level of Cor and the relative expression quantity of miR-27a were lower than those in the double incision group(P<0.05).The total incidence of postoperative complications in the single incision group was 3.33%,which was lower than 20.00%in the double incision group(P<0.05).Conclusion Compared with the double incision breast and axillary approach,the modified radical mastectomy with nipple areola preservation through single incision ring areola approach and immediate breast reconstruction has a better aesthetic effect,which can more effectively reduce the stress response and the expression level of miRNA in exosomes of patients.