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超声引导下Mammotome旋切术用于早期乳腺癌治疗的临床效果

Clinical efficacy of using ultrasound-guided Mammotome revolve device in treatment of early breast cancer
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摘要 目的:探讨超声引导下Mammotome旋切术用于早期乳腺癌的临床效果。方法:收集2015年1月-2018年6月接受超声引导下Mammotome旋切术完全切除病灶,术后病理确诊为早期乳腺癌并接受根治手术的患者51例患者资料,分析残腔边缘肿瘤残留情况及残腔肿瘤残留的危险因素。结果:51例患者中15例(29.4%)有肿瘤残留。确诊为乳腺癌后,37例患者接受乳房切除术,14例患者接受保乳根治术并切除针道,病理提示14例患者的针道中均未见癌细胞残留。单因素分析结果显示,乳腺癌病史,肿瘤组织学类型,组织学分级,激素受体及腋窝淋巴结状态对肿瘤残留无影响(均P>0.05);肿块直径(P=0.046),年龄(P=0.036)和Ki-67高表达(P=0.039)与肿瘤残留有关。多因素分析发现Ki-67高表达是独立的危险因素(OR=4.83,P=0.038)。结论:超声引导下Mammotome旋切术切除早期乳腺癌存在较高的肿瘤残留率,故须严格控制适应证来降低残留率,但其临床应用价值需进一步评估。 Objective: To investigate the clinical efficacy of using ultrasound-guided Mammotome revolve device in treatment of early-stage breast cancer.Methods: The clinical data of 51 patients who underwent complete lesion excision by ultrasound-guided Mammotome revolve device and then radical surgery because pathologically diagnosed as breast cancer after lesion excision between January 2015 and June 2018 were collected. The residual tumor in the margin of the resection cavity and the risk factors for residual tumor were analyzed.Results: Of the 51 patients, residual tumor was detected in 15 cases(29.4%). After diagnosis of breast cancer, 37 patients underwent mastectomy, and 14 patients received breast-conserving radical surgery with resection ofthe needle passage, and no residual tumor was found in the needle passage by pathological examination in any of the 14 cases. The results of univariate analysis showed that the history of breast cancer, histological type of the tumor, histological grade, hormone receptors and status of the axillary lymph nodes had no significant influence on tumor residues(all P>0.05); tumor diameter(P=0.046), age(P=0.036) and high Ki-67 expression(P=0.039) were associated with tumor residues. Results of multivariate analysis revealed that high Ki-67 expression was an independent risk factor for tumor residues(OR=4.83, P=0.038).Conclusion: There is a relatively high rate of residual tumor after early-stage breast cancer excision by ultrasoundguided Mammotome revolve device, so indications should be rigorously followed to reduce the chance of residual tumor.However, its clinical value needs to be further evaluated.
作者 薛丹青 方琦 XUE Danqing;FANG Qi(Department of Breast Surgery,the Third Affiliated Hospital,Soochow University,Changzhou,Jiangsu213003,China)
出处 《中国普通外科杂志》 CSCD 北大核心 2018年第11期1458-1463,共6页 Chinese Journal of General Surgery
关键词 乳腺肿瘤 乳房切除术 麦默通 肿瘤 残余 Breast Neoplasms Mastectomy Mammotome Neoplasm,Residual
作者简介 薛丹青,苏州大学附属第三医院主治医师,主要从事乳腺恶性肿瘤临床与基础方面的研究;通信作者:方琦,Email:mschristmas@foxmail.com
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