前哨淋巴结活检联合保乳术对早期乳腺癌的血清肿瘤标志物水平及创伤后应激障碍的影响

Effect of sentinel lymph node biopsy combined with breast-conserving surgery on serum tumor marker levels and post-traumatic stress disorder in early breast cancer

目的探讨前哨淋巴结活检联合保乳术对早期乳腺癌的血清肿瘤标志物水平及创伤后应激障碍(PTSD)的影响。方法选取2023年1月至10月于萍乡市人民医院就诊的80例早期乳腺癌患者作为研究对象,按照随机数字表法将其分为研究组与对照组,每组各40例。对照组患者行乳腺癌改良根治术,研究组患者采用前哨淋巴结活检联合保乳术。比较两组的围手术期指标、血清肿瘤标志物水平、PTSD评分、并发症总发生率,观察并统计观察组的前哨淋巴结活检情况。结果研究组的手术时间长于对照组,术中出血量、术后引流量均少于对照组,住院时间短于对照组,差异有统计学意义(P<0.05)。术后1周,研究组的癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原15-3(CA15-3)水平均低于对照组,差异有统计学意义(P<0.05)。术后1周,研究组的各项PTSD评分均低于对照组,差异有统计学意义(P<0.05)。研究组的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。观察组行前哨淋巴结活检,检出率为97.50%(39/40),每例患者中发现1~3枚前哨淋巴结,共检出前哨淋巴结46枚,经HE染色和连续切片可见前哨淋巴结阳性率为42.50%(17/40),伴有微转移3例。结论前哨淋巴结活检术联合保乳术在早期乳腺癌患者治疗中获得显著效果,有助于评估腋窝淋巴结情况,利于准确判断患者是否需要开展腋窝淋巴结清扫术,降低血清肿瘤标志物水平,且术后PTSD水平较轻,安全可靠,值得推广应用。

Objective To investigate the effect of sentinel lymph node biopsy combined with breast-conserving surgery on serum tumor marker levels and post-traumatic stress disorder(PTSD)in early breast cancer.Methods A total of 80 patients with early breast cancer who were treated in Pingxiang People's Hospital from January to October 2023 were selected as the research objects.According to the random number table method,they were divided into study group and control group,with 40 cases in each group.Patients in the control group were treated with modified radical mastectomy,and patients in the study group were treated with sentinel lymph node biopsy combined with breast conserving surgery.The perioperative indicators,serum levels of tumor markers,PTSD score,and total incidence of complications were compared between the two groups.Sentinel lymph node biopsy in the observation group was observed and counted.Results The operation time of the study group was longer than that of the control group,the intraoperative blood loss and postoperative drainage volume were less than those of the control group,and the hospitalization time was shorter than that of the control group,and the differences were statistically significant(P<0.05).One week after the operation,the levels of carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)and carbohydrate antigen 15-3(CA15-3)in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The scores of PTSD in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total complication rate of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).In the observation group,the detection rate of sentinel lymph node biopsy was 97.50%(39/40),1-3 sentinel lymph nodes were found in each patient,a total of 46 sentinel lymph nodes were detected,and the positive rate of sentinel lymph nodes was 42.50%(17/40)by HE staining and continuous section,with 3 cases of micrometastasis.Conclusion Sentinel lymph node biopsy combined with breast-conserving surgery has a significant effect in the treatment of early breast cancer patients,which is helpful to evaluate the condition of axillary lymph nodes,help to accurately determine whether the patients need to carry out axillary lymph node dissection,reduce the level of serum tumor markers,and the postoperative PTSD level is relatively mild,safe and reliable,and worthy of promotion and application.