保乳术联合前哨淋巴结活检术对乳腺癌患者生活质量、应激水平及血清肿瘤标志物的影响

Effects of Breast-conserving Surgery Combined with Sentinel Lymph Node Biopsy on Quality of Life,Stress Level and Serum Tumor Markers in Patients with Breast Cancer

目的:探究保乳术联合前哨淋巴结活检术对乳腺癌患者生活质量、应激水平及血清肿瘤标志物的影响。方法:回顾性研究常熟市第五人民医院2017年2月—2021年12月收治的102例乳腺癌患者的病例资料。根据治疗方案将其分为对照组和观察组,其中对照组51例接受保乳术治疗,观察组51例接受保乳术联合前哨淋巴结活检术治疗。比较两组手术指标,生活质量的情况、应激水平血管紧张素Ⅱ(AngⅡ)、肾上腺素(AD)、检测血清肿瘤标志物水平。结果:观察组手术时间短于对照组,术后引流量少于对照组(P<0.05)。两组1年后生活质量评分(总体健康、生理职能、生理功能、活力、躯体疼痛、社会功能、情感职能、精神健康)比较,差异均有统计学意义(P<0.05)。术前0.5 h,两组应激反应相关指标对比,差异均无统计学意义(P>0.05);术后1 d,两组AD、AngⅡ水平均升高(P>0.05),观察组AD、AngⅡ水平均低于对照组(P<0.05)。术前0.5 h,两组血清癌胚抗原(CEA)和糖类抗原153(CA153)水平比较,差异均无统计学意义(P>0.05);术后1 d,两组血清CA153、CEA水平均低于术前0.5 h(P<0.05),观察组CA153、CEA水平均低于对照组(P<0.05)。结论:保乳术联合前哨淋巴结活检术应用于乳腺癌患者治疗中,更有助于缩短手术时间等手术指标,提高患者的生活质量,调节应激反应,且术后短期肿瘤标志物调节水平较低。

Objective:To explore the effects of breast conserving surgery combined with sentinel lymph node biopsy on quality of life,stress level and serum tumor markers in patients with breast cancer.Method:The data of 102 patients with breast cancer admitted to Changshu No.5 People's Hospital from February 2017 to December 2021 were retrospectively studied.According to the treatment plan,they were divided into control group and observation group,among which 51 cases in the control group received breast-conserving surgery treatment,and 51 cases in the observation group received breast-conserving surgery combined with sentinel lymph node biopsy.The surgical indexes,quality of life,stress levels of angiotensinⅡ(AngⅡ),adrenaline(AD)and serum tumor markers were compared between the two groups.Result:The operation time of observation group was shorter than that of control group,the postoperative drainage volume was lower than that in the control group(P<0.05).There were statistically significant differences after 1-year quality of life scores(general health,physiological function,physiological function,vitality,physical pain,social function,emotional function,mental health)between the two groups(P<0.05).At 0.5 h before surgery,there were no statistical significance differences in the relevant indexes of stress response between the two groups(P>0.05);1 d after surgery,the levels of AD and AngⅡwere increased between the two groups(P>0.05),and the levels of AD and AngⅡin the observation group were lower than those in the control group(P<0.05).At 0.5 h before surgery,there were no statistically significant differences in the levels of carcinoembryonic antigen(CEA)and carbohydrate antigen 153(CA153)between two groups(P>0.05);1 d after operation,serum CA153 and CEA levels in two groups were lower than those 0.5 h before operation(P<0.05),and CA153 and CEA levels in observation group were lower than those in control group(P<0.05).Conclusion:The application of breastconserving surgery combined with sentinel lymph node biopsy in the treatment of breast cancer patients is more helpful to shorten the operation time and other surgical indicators,improve the quality of life of patients,regulate stress response,and the short-term postoperative tumor marker regulation level is lower.