摘要
目的观察保留乳头乳晕的乳腺癌改良根治术对乳腺癌患者细胞免疫功能及甲状腺激素水平的影响。方法选取2013年3月—2015年3月收治的乳腺癌112例,根据治疗方式分为观察组和对照组,每组56例。对照组给予传统乳腺癌改良根治术,观察组给予保留乳头乳晕乳腺癌改良根治术。观察治疗后2组临床疗效、预后、T细胞亚群及甲状腺激素水平变化情况。结果观察组治疗后美容效果优良率高于对照组(P <0. 01)。2组治疗后生活质量各维度评分均高于治疗前,且观察组高于对照组(P <0. 05,P <0. 01)。2组治疗后CD8+水平高于治疗前,血清CD4+与CD4+/CD8+水平低于治疗前(P <0. 05,P <0. 01);观察组CD8+水平低于对照组,血清CD4+与CD4+/CD8+水平高于对照组(P <0. 05,P <0. 01)。2组治疗后血清游离三碘甲腺原氨酸和血清游离甲状腺素水平高于治疗前,且观察组高于对照组(P <0. 05)。结论保留乳头乳晕的乳腺癌改良根治术临床效果较好,可提高患者术后生活质量,改善机体细胞免疫功能和甲状腺激素水平,降低术后复发率。
Objective To investigate effects of modified radical mastectomy with keeping nipple and areola papillaris on cellular immune function and thyroid hormone level in patients with breast cancer. Methods A total of 112 breast cancer patients admitted during March 2015 and March 2017 were divided into observation group and control group(n = 56 in each group) according to different treatment methods. Control group was treated with modified radical mastectomy,while observation group was treated with modified radical mastectomy with keeping nipple and areola papillaris.Clinical efficacy,prognosis,changes of T cell subsets and thyroid hormone level after treatment were observed in the two groups. Results After treatment,good rate of cosmetic result in observation group was significantly higher than that in control group(P < 0. 01); scores of life quality were significantly higher than those before treatment in two groups,and the scores in observation group were significantly higher than those in control group(P < 0. 05,P < 0. 01). After treatment,CD8 + levels were significantly higher,while serum CD4 + and CD4 +/CD8 + levels were significantly lower than those before treatment in two groups(P < 0. 05,P < 0. 01); in observation group,CD8 + level was significantly lower,while serum CD4 + and CD4 +/CD8 + levels were significantly higher than those in control group(P < 0. 05).After treatment,serum free triiodothyronine(FT3) and free(unbound) thyroxin(e)(FT4) levels were significantly higher than those before treatment in two groups,and the levels in observation group were significantly higher than those in control group(P < 0. 05,P < 0. 01). Conclusion Modified radical mastectomy with keeping nipple and areola papillaris may achieve good effectiveness,improve quality of life,immune function of the body and thyroid hormone level and reduce postoperative recurrence rate.
引文
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