超声引导下亚甲基蓝切缘定位对行保乳术的早期乳腺癌患者临床疗效的影响

Effect of ultrasound-guided methylene blue margin localization on clinical efficacy of breast for patient with early breast cancer

目的 探讨超声引导下亚甲基蓝切缘定位对行保乳术的早期乳腺癌患者临床疗效的影响。方法 纳入驻马店市中心医院2019年1月到2020年12月收治的108例行保乳术的早期乳腺癌患者。根据是否行超声引导下亚甲基蓝标记切缘定位,分为常规组和亚甲基蓝定位组。比较手术相关指标、最大切缘、一次性切缘阳性率、并发症发生率、术后美容效果、无进展生存率和复发率。结果 亚甲基蓝定位组手术总时长明显短于常规组,术中总失血量明显低于常规组(P<0.05)。亚甲基蓝定位组最大切缘≤2 cm患者占比明显高于常规组,一次性切缘阳性率明显低于常规组(P<0.05);亚甲基蓝定位组并发症发生率明显低于常规组(P<0.05);术后3个月,亚甲基蓝定位组乳房外观美容效果优良率明显高于常规组(P<0.05);术后1年,两组两组患者均无复发病例。术后2年,亚甲基蓝定位组复发率与常规组比较,无显著差异(P<0.05)。结论 超声引导下采用亚甲基蓝对肿瘤病灶的切缘进行定位,可显著缩短手术总时长,降低术中总失血量,促进患者快速康复,提高病灶切除精确性,缩小切缘,降低一次性切缘阳性率,改善乳腺美容效果,但术后并发症发生率较低,安全性较高,值得在早期乳腺癌保乳术中推广使用。

Objective To investigate the effect of ultrasound-guided methylene blue localization on the clinical efficacy of breast conserving surgery in patients with early breast cancer.Methods Totally 108 patients with early breast cancer who underwent breast conserving surgery in the Zhumadian Central Hospital from Jan.2019 to Dec.2020 were included and divided into routine group and methylene blue localization group according to whether the lesion was marked with methylene blue under ultrasound guidance.The surgical related indexes,the maximum margin,the positive rate of one-time margin,the incidence of complications,the postoperative cosmetic effect,the progression free survival rate and the recurrence rate were compared between the two group.Results Methylene blue localization group the total operation time was shorter than that of routine group,and the total intraoperative blood loss was lower than that of routine group(P<0.05).The proportion of patients with maximum margin≤2 cm in methylene blue localization group was higher than that in routine group,and the positive rate of one-time margin was lower than that in routine group(P<0.05);the incidence of complications in methylene blue localization group was lower than that in routine group(P<0.05);after 3 months of operation,the excellent rate of breast cosmetic effect in methylene blue localization group was higher than that in routine group(P<0.05);after 1 year of operation,there was no recurrence in both groups;After 2 years of operation,the recurrence rate was no significant difference between the two groups(P<0.05).Conclusion Ultrasound-guided methylene blue margin localization for breast conserving surgery in patients with early breast cancer can significantly shorten the total operation time,reduce the total intraoperative blood loss,promote the rapid recovery of patients,improve the accuracy of lesion resection,reduce the cutting edge,reduce the positive rate of one-time cutting edge,and improve the cosmetic effect of breast,but the incidence of postoperative complications is low,and the safety is high.It is worth popularizing in breast conserving surgery for early breast cancer.