CAJ | 학술논문

目的探讨保留肋间臂神经(ICBN)的乳腺癌腋淋巴结清扫术的安全性.方法留取2013年1-10月间河北联合大学附属医院肿瘤外科乳腺癌常规手术中切除的57例ICBN及其周围组织,进行HE染色,镜下观察其病理变化,对镜下见有癌细胞浸润者,免疫组化法检测癌细胞中人乳腺珠蛋白(hMAM)等4种标志物的表达.结果 57例切除的ICBN及周围组织,55例未见癌细胞浸润,27例伴患侧腋窝淋巴结肿大的患者中1例可见ICBN受癌细胞浸润,1例于神经周围组织中可见癌细胞;浸润ICBN的癌细胞雌激素受体(ER)、孕激素受体(PR)、hMAM、大囊泡病液体蛋白-15(GCDFP-15)均阳性表达,浸润周围组织的癌细胞ER、PR、hMAM阳性表达,GCDFP-15阴性表达.结论除非ICBN与肿大的淋巴结粘连严重而将其切除外,保留ICBN的乳腺癌手术是安全可行的.
목적 탐토보류륵간비신경(ICBN)적유선암액림파결청소술적안전성.방법 류취2013년1-10월간하북연합대학부속의원종류외과유선암상규수술중절제적57례ICBN급기주위조직,진행HE염색,경하관찰기병리변화,대경하견유암세포침윤자,면역조화법검측암세포중인유선주단백(hMAM)등4충표지물적표체.결과 57례절제적ICBN급주위조직,55례미견암세포침윤,27례반환측액와림파결종대적환자중1례가견ICBN수암세포침윤,1례우신경주위조직중가견암세포;침윤ICBN적암세포자격소수체(ER)、잉격소수체(PR)、hMAM、대낭포병액체단백-15(GCDFP-15)균양성표체,침윤주위조직적암세포ER、PR、hMAM양성표체,GCDFP-15음성표체.결론 제비ICBN여종대적림파결점련엄중이장기절제외,보류ICBN적유선암수술시안전가행적.
Objective To explore the reliability of preserving intercostobrachial nerve (ICBN) during axillary lymph node dissection for breast carcinoma.Methods A total of 57 patients with breast carcinoma undergoing routine operations were analyzed.The extirpated ICBN and ambient tissues were tested by hematoxylin and eosin staining to observe the pathological changes under microscope.If there was an infiltration of carcinoma,4 immunohistochemical markers,including human mammaglobin (hMAM),were tested in related tissue.Results Among them,no microscopic infiltration of carcinoma was found in 55cases.In 27 cases with axillary lymph node metastasis,1 case had an infiltration of carcinoma and carcinoma cells were present in tissues around ICBN in another case.Immunohistochemistry showed that hMAM,GCDFP-15,estrogen receptor (ER) and progesterone receptor (PR) were all positive in infiltrated ICBN.And carcinoma cells in tissues around ICBN expressed ER,PR and hMAM positively and GCDFP-15negatively.Conclusion Unless intercostobrachial nerves and enlarged lymph nodes adhere heavily,preserving ICBN is feasible for breast carcinoma surgery.