CAJ | 학술논문

目的探讨乳腺导管内癌(DCIS)的临床特点、治疗及预后.方法回顾性分析天津医科大学附属肿瘤医院1991年1月至2005年12月收治的430例DCIS患者的临床病理资料,探讨其临床特点及不同治疗方式对预后的影响.结果 430例DCIS患者总生存率为94.9％ (408/430),10例因乳腺癌原因死亡,其中7例因癌局部复发死亡,3例死于远处器官转移.肿瘤最大径、TNM分期及病理组织结构类型对预后影响差异有统计学意义(P＜0.05).术后辅助放疗的保乳手术5年生存率100％,10年生存率97.1％;传统的乳腺癌改良根治术总的5年生存率98.3％,10年生存率96.7％,二者生存率差异无统计学意义(P＞0.05);单纯手术组总生存率89.9％,术后辅助治疗组总生存率为96.8％,术后辅助治疗组较单纯手术组能改善预后(P＜0.05).结论乳腺导管内癌应根据肿瘤最大径、组织学特点等综合设计个体化治疗方案.保乳手术可获得与传统乳腺癌改良根治术相同的预后效果.
목적 탐토유선도관내암(DCIS)적림상특점、치료급예후.방법 회고성분석천진의과대학부속종류의원1991년1월지2005년12월수치적430례DCIS환자적림상병리자료,탐토기림상특점급불동치료방식대예후적영향.결과 430례DCIS환자총생존솔위94.9％ (408/430),10례인유선암원인사망,기중7례인암국부복발사망,3례사우원처기관전이.종류최대경、TNM분기급병리조직결구류형대예후영향차이유통계학의의(P＜0.05).술후보조방료적보유수술5년생존솔100％,10년생존솔97.1％;전통적유선암개량근치술총적5년생존솔98.3％,10년생존솔96.7％,이자생존솔차이무통계학의의(P＞0.05);단순수술조총생존솔89.9％,술후보조치료조총생존솔위96.8％,술후보조치료조교단순수술조능개선예후(P＜0.05).결론 유선도관내암응근거종류최대경、조직학특점등종합설계개체화치료방안.보유수술가획득여전통유선암개량근치술상동적예후효과.
Objective To explore the clinical characteristics,treatment and prognosis of ductal carcinoma in situ of the breast.Methods We retrospectively analysed 430 patients with a diagnosis of DCIS in Cancer Hospital of Tianjin Medical University from January 1991 to December 2005,to evaluate the clinical characteristics,treatment and prognosis.Results Overall survival rate of 430 patients was 94.9％ (408/430).10 cases died of breast cancer recurrence,7 for local recurrence,3 for metastsis.Tumor size,TNM stages and structural pattern of pathlogy were prognosis impacting factors (P ＜ 0.05).The 5-year survival rate for combination radiotherapy and breast-conserving surgery group was 100％,and 10-year survival rate was 97.1％,comparing traditional modified radical mastectomy 5-year survival rate of 98.3％and 10-year survival of 96.7％ (P ＞ 0.05).The overall survival rate of surgery alone group (89.9％) was lower than the post-operative comprehensive treatment group (96.8％),(P ＜ 0.05).Conclusions Treatment of DCIS should be based on primary tumor's clinical stage and histologic characters.Breast-conserving surgery enjoys the same outcome as traditional modified radical mastectomy.