保留乳头乳晕的乳腺癌改良根治术与传统乳腺癌改良根治术的临床效果比较

Comparative Analysis of the Clinical Effects of Modified Radical Mastectomy and Conventional Modified Radical Mastectomy for Breast Cancer with Preserved Nipple Areola

目的对比分析保留乳头乳晕的乳腺癌改良根治术(NSM)和传统乳腺癌改良根治术(MRM)的临床效果。方法选择78例早期乳腺癌患者,采用随机数字表法分为两组,每组各39例。对照组实施MRM,观察组实施NSM。对比两组乳房美容效果、激素水平、免疫功能、局部复发率及远处转移率。结果观察组乳房美容优良率(92.31%)高于对照组(71.29%),血清游离甲状腺素(FT4)(33.30±12.11)pmol/l、游离三碘甲腺原氨酸(FT3)(15.14±2.38)pmol/l,高于对照组的(22.74±10.24)pmol/l、(9.28±1.52)pmol/l,CD4^(+)(24.51±4.28)、CD4^(+)/CD8^(+)(1.65±0.47)高于对照组的(13.41±3.14)、(0.80±0.39),CD8^(+)(21.54±2.39)低于对照组的(32.05±2.70),差异有统计学意义(P<0.05)。两组复发率、远处转移率比较,差异无统计学意义(P>0.05)。结论NSM和MRM治疗早期乳腺癌均能有效控制远处转移率和复发率,但在提高美容效果、改善激素水平和免疫功能方面NSM优于MRM。

Objective To compare and analyze the clinical effects of modified radical mastectomy(NSM)and traditional modified radical mastectomy(MRM)with nipple areola.Methods 78 patients with early breast cancer were selected and divided into 2 groups,39 cases in each group.MRM in the control group,and NSM in the observation group.The effect of breast beauty,hormone level,immune function,local recurrence rate and distant metastasis rate were compared between the 2 groups.Results The excellent rate of breast beauty in the observation group(92.31%)was higher than that of the control group(71.29%),Serum free thyroxine(FT4)(33.30±12.11)pmol/l、free triiodothyronine(FT3)(15.14±2.38)pmol/l,which were higher than the control group(22.74±10.24)pmol/l、(9.28±1.52)pmol/l;CD4^(+)(24.51±4.28),CD4^(+)/CD8^(+)(1.65±0.47),which were higher than the control group(13.41±3.14),(0.80±0.39),CD8^(+)(21.54±2.39)was lower than the control group(32.05±2.70),the difference was statistically significant(P<0.05).Comparison of recurrence rate,distant metastasis rate,and the difference was not statistically significant(P>0.05).Conclusion NSM and MRM treatment of early breast cancer can effectively control the distant metastasis rate and recurrence rate,but it is better than MRM in improving beauty effect,hormone level and immune function.