CAJ | 학술논문

目的：通过术中组织冰冻切片检查和相应组织骨桥蛋白水平表达检测，找出病理检查难以发现的隐性癌灶，为临床实施保乳手术界定切缘提供理论依据。方法距瘤体组织0.5、1.0、1.5、2.0、2.5、3.0 cm分别切除标本行冰冻切片检查，实时荧光定量逆转录聚合酶链反应（qRT-PCR ）技术检测骨桥蛋白表达。结果癌旁0.5、1.0 cm处骨桥蛋白表达阳性比例高于1.5 cm处（P＜0.05），1.5 cm与2.0 cm处之间差异无统计学意义（P＞0.05），其中有2个样本距离瘤组织边缘3 cm处骨桥蛋白仍表达阳性。结论早期乳腺癌保乳手术切缘切除范围1.5 cm为安全切缘，但合适的切缘范围应有个体差异，取决于患者年龄、细胞组织学和自身选择。
목적：통과술중조직빙동절편검사화상응조직골교단백수평표체검측，조출병리검사난이발현적은성암조，위림상실시보유수술계정절연제공이론의거。방법거류체조직0.5、1.0、1.5、2.0、2.5、3.0 cm분별절제표본행빙동절편검사，실시형광정량역전록취합매련반응（qRT-PCR ）기술검측골교단백표체。결과암방0.5、1.0 cm처골교단백표체양성비례고우1.5 cm처（P＜0.05），1.5 cm여2.0 cm처지간차이무통계학의의（P＞0.05），기중유2개양본거리류조직변연3 cm처골교단백잉표체양성。결론조기유선암보유수술절연절제범위1.5 cm위안전절연，단합괄적절연범위응유개체차이，취결우환자년령、세포조직학화자신선택。
Objective To provide evidence for the surgical marginal distance from tumor edge in clinical breast-conserving operation through examining the pathologic elusive hidden cancerous foci range by frozen section examination and osteopontin expression level .Methods The specimens located at different distances (0.5 ,1.0 , 1.5 ,2.0 ,2.5 ,3.0 cm) from tumor edge were detected by using frozen section examination and qRT-PCR tech-nique for osteopontin expression .Results The positive rate of risk factors at 0.5 cm and 1.0 cm from tumor edge was significantly higher than that of 1.5 cm(P<0.05) .However ,there is no significant difference between the positive rate of 2.0 cm and 1.5 cm (P> 0.05) .Risk factors still existed in 2 specimens at 3.0 cm from tumor edge ,and the osteopontin expression of their primary tumors were still positive .Conclusion The resection should be extended up to 1.5 cm from tumor edge in breast-conserving surgery for those patients with primary breast cancer .Alternatively ,detailed longitudinal data was needed to balance the value and the cost of wide margins . Until further data are available ,the desirable margin width will be various depending on ages ,histological expres-sion and patient preference .