国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2013年
3期
150-153
,共4页
康华峰%代志军%马小斌%包兴%林帅%刘小旭%王西京
康華峰%代誌軍%馬小斌%包興%林帥%劉小旭%王西京
강화봉%대지군%마소빈%포흥%림수%류소욱%왕서경
乳腺肿瘤%癌%保乳手术%超声检查
乳腺腫瘤%癌%保乳手術%超聲檢查
유선종류%암%보유수술%초성검사
Breast neoplasms%Carcinoma%Breast conservative-surgery%Ultrasonography
目的 探讨乳腺癌保乳手术术中超声实时监测的可行性及其对切缘阳性率、切除乳腺组织的影响.方法 55例T1-2N0-1浸润性乳腺癌患者抽签法随机分为触诊引导组(对照组)26例和超声引导组(实验组)29例,实验组术前在高频超声指引下勾画出距肿瘤边缘1 cm轮廓,术中超声监测切除肿瘤及周围1 cm腺体组织.组织切片冰冻活检确定切缘阴性,记录切缘阳性率、近切缘阳性率及乳腺组织切除体积.结果 对照组和实验组两组患者临床病理特征具有可比性.实验组切缘阳性率为0,对照组为3.85％,实验组略低于对照组,差异无统计学意义(P =0.473 ＞0.05);实验组近切缘阳性率为3.45％,对照组为15.38％,实验组低于对照组,但差异无统计学意义(x2=1.140,P＞0.05);实验组切缘再切除率为3.45％,对照组为19.23％,实验组低于对照组,但差异无统计学意义(x2 =2.077,P＞0.05)；实验组乳腺组织切除体积为(32.40±10.93) cm3,对照组为(55.11±12.88) cm3,实验组低于对照组,差异具有统计学意义(=7.072,P ＜0.01).结论 术中超声监测能有效降低乳腺癌保乳手术的切缘阳性率,减少正常乳腺组织的切除,提高美容效果.
目的 探討乳腺癌保乳手術術中超聲實時鑑測的可行性及其對切緣暘性率、切除乳腺組織的影響.方法 55例T1-2N0-1浸潤性乳腺癌患者抽籤法隨機分為觸診引導組(對照組)26例和超聲引導組(實驗組)29例,實驗組術前在高頻超聲指引下勾畫齣距腫瘤邊緣1 cm輪廓,術中超聲鑑測切除腫瘤及週圍1 cm腺體組織.組織切片冰凍活檢確定切緣陰性,記錄切緣暘性率、近切緣暘性率及乳腺組織切除體積.結果 對照組和實驗組兩組患者臨床病理特徵具有可比性.實驗組切緣暘性率為0,對照組為3.85％,實驗組略低于對照組,差異無統計學意義(P =0.473 ＞0.05);實驗組近切緣暘性率為3.45％,對照組為15.38％,實驗組低于對照組,但差異無統計學意義(x2=1.140,P＞0.05);實驗組切緣再切除率為3.45％,對照組為19.23％,實驗組低于對照組,但差異無統計學意義(x2 =2.077,P＞0.05)；實驗組乳腺組織切除體積為(32.40±10.93) cm3,對照組為(55.11±12.88) cm3,實驗組低于對照組,差異具有統計學意義(=7.072,P ＜0.01).結論 術中超聲鑑測能有效降低乳腺癌保乳手術的切緣暘性率,減少正常乳腺組織的切除,提高美容效果.
목적 탐토유선암보유수술술중초성실시감측적가행성급기대절연양성솔、절제유선조직적영향.방법 55례T1-2N0-1침윤성유선암환자추첨법수궤분위촉진인도조(대조조)26례화초성인도조(실험조)29례,실험조술전재고빈초성지인하구화출거종류변연1 cm륜곽,술중초성감측절제종류급주위1 cm선체조직.조직절편빙동활검학정절연음성,기록절연양성솔、근절연양성솔급유선조직절제체적.결과 대조조화실험조량조환자림상병리특정구유가비성.실험조절연양성솔위0,대조조위3.85％,실험조략저우대조조,차이무통계학의의(P =0.473 ＞0.05);실험조근절연양성솔위3.45％,대조조위15.38％,실험조저우대조조,단차이무통계학의의(x2=1.140,P＞0.05);실험조절연재절제솔위3.45％,대조조위19.23％,실험조저우대조조,단차이무통계학의의(x2 =2.077,P＞0.05)；실험조유선조직절제체적위(32.40±10.93) cm3,대조조위(55.11±12.88) cm3,실험조저우대조조,차이구유통계학의의(=7.072,P ＜0.01).결론 술중초성감측능유효강저유선암보유수술적절연양성솔,감소정상유선조직적절제,제고미용효과.
Objective To evaluate the feasibility of intra-operative ultrasound guide in breast conservative-surgery and its effect on positive margin rate and breast tissue volume.Methods Fifty-five cases of invasive breast cancer staged T1-2N0-1 were randomly assigned to palpation-guided group(control group) 26 cases and ultrasound-guided group(experiment group) 29 cases.Before and during operation,high-frequency ultrasound was used to guide the resection of breast cancer with 1 cm margin in experiment group.The resection margin positive rate deteced by tissue section frozen biopsy and resected breast tissue volume were compared between experiment and control group.Results The clinicopathologic features were accordant between two groups.The margin positive rate and near-margin positive rate in experiment group were 0 and 3.45％ respectively,slightly lower than that of control group 3.85％ and 15.38％,but with no statistical significance (P ＞ 0.05).The same situation occurred at the re-exision rate.The resected breast tissue volume in experiment group (32.40 ± 10.93) cm3 was lower than that of control group (55.11 ± 12.88) cm3,and with statistical significance (P ＜ 0.01).Conclusions Intra-operative ultrasound guide could reduce the margin positive rate and unnecessary resected brcast tissue volume in breast conservative-surgery,and improve cosmetic effect.
