CAJ | 학술논문

目的旨在观察局部进展期乳腺癌新辅助化疗时腋淋巴结及结外侵犯的临床病理学改变.方法 2002年6月-2009年8月南京大学附属第二医院收治的肿块大于5 cm伴同侧腋淋巴结肿大但不融合的86例患者,以患者是否愿意行新辅助化疗分组,A组患者46例,不愿行新辅助化疗,穿刺确诊后行手术治疗,术后病理证实,腋淋巴结转移40例,转移腋淋巴结结外侵犯17例.B组患者40例,自愿行新辅助化疗,穿刺确诊后平均行3个周期新辅助化疗,再行手术治疗,术后病理证实,腋淋巴结转移26例,转移腋淋巴结结外侵犯6例.结果 A组患者淋巴结转移率为86.9%,转移淋巴结并结外侵犯率为36.9%;B组患者淋巴结转移率为65%,转移淋巴结结外侵犯率为15%,两组病例在淋巴结转移率及转移淋巴结结外侵犯率之间存在显著差异,P<0.05.结论新辅助化疗对于患者的腋淋巴结转移灶有明显作用,减少了淋巴结转移率及转移淋巴结结外侵犯率.
목적 지재관찰국부진전기유선암신보조화료시액림파결급결외침범적림상병이학개변.방법 2002년6월-2009년8월남경대학부속제이의원수치적종괴대우5 cm반동측액림파결종대단불융합적86례환자,이환자시부원의행신보조화료분조,A조환자46례,불원행신보조화료,천자학진후행수술치료,술후병리증실,액림파결전이40례,전이액림파결결외침범17례.B조환자40례,자원행신보조화료,천자학진후평균행3개주기신보조화료,재행수술치료,술후병리증실,액림파결전이26례,전이액림파결결외침범6례.결과 A조환자림파결전이솔위86.9%,전이림파결병결외침범솔위36.9%;B조환자림파결전이솔위65%,전이림파결결외침범솔위15%,량조병례재림파결전이솔급전이림파결결외침범솔지간존재현저차이,P<0.05.결론 신보조화료대우환자적액림파결전이조유명현작용,감소료림파결전이솔급전이림파결결외침범솔.
Objective To investigate histopathological change of axillary lymph nodes and ecto-node encroachment of breast cancer following neoadjuvant chemotherapy in locally advanced breast cancer.Methods Second Hospital Affiliated to University of South China had received 86 patients with breast carcinoma from June 2002 to August 2009,these patients suffered lump over 5 cm and homonymy nonfusion lymphadenectasis.All samples were grouped on the basis of wether or not accept neoadjuvant chemotherapy.The first group included 46 patients,who were reluctant to receive neoadjuvant chemotherapy,operated after pricking pathological diagnosis.There were 40 patients with metastatic axillary lymph nodes and 17 patients with axillary ecto-node encroachment in the first group.The second group included 40 patients,who were voluntary to receive neoadjuvant chemotherapy,and operated after pricking pathological diagnosis and received three cycles of neoadjuvant chemotherapy on average.There were 26 patients with metastatic axillary lymph nodes and 6 patients with axillary ecto-node encroachment in the second group.Results The rate of metastatic axillary lymph nodes was 86.9% and the rate of axillary ecto-node encroachment was 36.9% in the first group,while 65% and 15% respectively in the scond group.There were significant deference in the rate of metastatic lymph node and axillary ecto-node encroachmen between two groups.Conclusion Neoadjuvant chemotherapy is effective to treat metastatic lymph node and axillary ecto-node encroachment in breast cancer.