前哨淋巴结活检术对早期乳腺癌患者生活质量与复发风险的研究
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摘要
目的探讨前哨淋巴结活检术对早期乳腺癌患者生活质量与复发风险的影响。方法在该院收治的早期乳腺癌患者中,方便选取60例于2012年1月—2013年12月期间实施治疗的患者作为研究对象;按照患者治疗方式不同分为两组,各30例;一组为对照组,行腋窝淋巴结清扫术联合乳房全切或保乳术治疗;另一组为研究组,行前哨淋巴结活检术联合乳房全切或保乳术治疗;观察与比较两组术后生活质量以及复发情况。结果术后1年、3年、5年,研究组上臂周径与肩关节最大外展角度优于对照组,差异有统计学意义(术后1年上臂周径t=2.59、术后3年上臂周径t=2.67、术后5年上臂周径t=2.59;术后1年最大外展角度t=13.43、术后3年最大外展角度t=5.69、术后5年最大外展角度t=11.10,P<0.05),研究组中实施全乳切除术的患者引流管留置时间为(7.12±0.78)d;对照组患者中,采用保乳手术治疗的患者引流管留置时间为(9.41±0.86)d,实施全乳切除术的患者引流管留置时间为(11.31±1.40)d,分别与研究组比较,时间皆长于研究组,差异有统计学意义(t=4.82、8.30,P<0.01)。而上肢功能障碍发生率(6.67%)低于对照组(30.30%),差异有统计学意义(χ~2=5.45,P=0.02);研究组疾病复发率(3.33%)与对照组(6.67%)比较则差异无统计学意义(χ~2=0.35,P=0.55)。结论应用前哨淋巴结活检术治疗早期乳腺癌患者,有助于提升患者术后生活质量,同时降低复发风险。
Objective To investigate the effect of sentinel lymph node biopsy on the quality of life and risk of recurrence in patients with early breast cancer. Methods Among the early breast cancer patients admitted to the hospital, 60 patients who underwent treatment from January 2012 to December 2013 were convenient selected as the study subjects. According to the different treatment methods, the patients were divided into two groups, 30 cases each; For the control group, axillary lymph node dissection combined with total breast or breast conserving surgery; the other group was the study group, sent sentinel lymph node biopsy combined with total breast or breast conserving surgery; observed and compared postoperative quality of life in the two groups and the recurrence. Results The maximal abduction angle of the upper arm circumference and shoulder joint of the study group was better than that of the control group at 1 year, 3 years and 5 years after operation the upper arm circumference diameter t=2.59 and the 3 year postoperative upper arm circumference diameter t=2.67. 5 years after operation, the upper arm circumference diameter t=2.59; the maximum abduction angle t=13.43 in 1 year after operation, the maximum abduction angle t=5.69 in 3 years after operation, and the maximum abduction angle t=11.10 in 5 years after operation, P<0.05), the indwelling time of the drainage tube was(7.12±0.78) d in the patients who underwent total mastectomy in the study group. In the control group, the drainage tube indwelling time was(9.41±0.86) d. The indwelling time of the drainage tube was(11.31±1.40)d, and the time was longer than that of the study group,the difference was statistically signficant(t =4.82, 8.30, P <0.01). The incidence of upper limb dysfunction(6.67%) was lower than that of the control group(30.30%),the difference was statistically signficant(χ~2=5.45, P=0.02). There was no significant difference in the disease recurrence rate(3.33%) between the study group and the control group(6.67%),the difference was not statistically signficant(χ~2= 0.35, P=0.55). Conclusion The use of sentinel lymph node biopsy in the treatment of patients with early breast cancer can improve the quality of life after surgery and reduce the risk of recurrence.
Objective To investigate the effect of sentinel lymph node biopsy on the quality of life and risk of recurrence in patients with early breast cancer. Methods Among the early breast cancer patients admitted to the hospital, 60 patients who underwent treatment from January 2012 to December 2013 were convenient selected as the study subjects. According to the different treatment methods, the patients were divided into two groups, 30 cases each; For the control group, axillary lymph node dissection combined with total breast or breast conserving surgery; the other group was the study group, sent sentinel lymph node biopsy combined with total breast or breast conserving surgery; observed and compared postoperative quality of life in the two groups and the recurrence. Results The maximal abduction angle of the upper arm circumference and shoulder joint of the study group was better than that of the control group at 1 year, 3 years and 5 years after operation the upper arm circumference diameter t=2.59 and the 3 year postoperative upper arm circumference diameter t=2.67. 5 years after operation, the upper arm circumference diameter t=2.59; the maximum abduction angle t=13.43 in 1 year after operation, the maximum abduction angle t=5.69 in 3 years after operation, and the maximum abduction angle t=11.10 in 5 years after operation, P<0.05), the indwelling time of the drainage tube was(7.12±0.78) d in the patients who underwent total mastectomy in the study group. In the control group, the drainage tube indwelling time was(9.41±0.86) d. The indwelling time of the drainage tube was(11.31±1.40)d, and the time was longer than that of the study group,the difference was statistically signficant(t =4.82, 8.30, P <0.01). The incidence of upper limb dysfunction(6.67%) was lower than that of the control group(30.30%),the difference was statistically signficant(χ~2=5.45, P=0.02). There was no significant difference in the disease recurrence rate(3.33%) between the study group and the control group(6.67%),the difference was not statistically signficant(χ~2= 0.35, P=0.55). Conclusion The use of sentinel lymph node biopsy in the treatment of patients with early breast cancer can improve the quality of life after surgery and reduce the risk of recurrence.
引文
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[7]齐长磊,余勤,张海强,等.前哨淋巴结活检术在甲状腺癌手术中的应用[J].中国地方病防治杂志,2016,31(5):539-540.
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[9]唐铁雷,李有怀,陈元元,等.纳米炭示踪法在老年乳腺癌患者前哨淋巴结活检术中的应用[J].中国老年学杂志,2015,35(22):6450-6451.
[10]张珊,曾繁余,唐巍,等.保乳联合前哨淋巴结活检对老年乳腺癌患者的疗效及对术后生活质量及美容效果的影响[J].实用癌症杂志,2016,31(1):124-127.
[11]孙荣能,赵迎春,陈剑平.保乳联合前哨淋巴结活检术对早期乳腺癌患者生活质量的影响[J].中国地方病防治杂志,2017,32(2):221-222.
[12]彭歆,徐贵颖,王长青,等.保乳联合前哨淋巴结活检在50例早期乳腺癌治疗中的临床价值[J].中国妇幼保健,2014,29(35):5935-5937.
[2]孙旭凌,黄桂林,申婧,等.吲哚菁绿联合亚甲蓝在早期乳腺癌前哨淋巴结活检术中的应用价值[J].山东医药,2017,57(9):48-50.
[3]王立峰.前哨淋巴结活检术在早期乳腺癌患者保乳手术中的应用[J].中国肿瘤临床与康复,2015,3(2):188-190.
[4]刘和荣,周厚吾,沈文华.乳腺癌保乳+前哨淋巴结活检术的应用效果评价与技术探讨[J].广东医学,2017,38(S1):69-71,73.
[5]毕钊,邱鹏飞,王永胜.乳腺癌内乳区淋巴结诊疗的研究进展[J].中国肿瘤临床,2017,44(21):1104-1107.
[6]王宏,曹旭晨,杨绍时,等.保乳联合前哨淋巴结活检术治疗早期乳腺癌患者80例临床观察[J].山东医药,2015,55(45):54-56.
[7]齐长磊,余勤,张海强,等.前哨淋巴结活检术在甲状腺癌手术中的应用[J].中国地方病防治杂志,2016,31(5):539-540.
[8]曹晓珊,王春建,刘雁冰,等.男性乳腺癌行腋窝及内乳前哨淋巴结活检术1例[J].中国普通外科杂志,2015,24(5):773-774.
[9]唐铁雷,李有怀,陈元元,等.纳米炭示踪法在老年乳腺癌患者前哨淋巴结活检术中的应用[J].中国老年学杂志,2015,35(22):6450-6451.
[10]张珊,曾繁余,唐巍,等.保乳联合前哨淋巴结活检对老年乳腺癌患者的疗效及对术后生活质量及美容效果的影响[J].实用癌症杂志,2016,31(1):124-127.
[11]孙荣能,赵迎春,陈剑平.保乳联合前哨淋巴结活检术对早期乳腺癌患者生活质量的影响[J].中国地方病防治杂志,2017,32(2):221-222.
[12]彭歆,徐贵颖,王长青,等.保乳联合前哨淋巴结活检在50例早期乳腺癌治疗中的临床价值[J].中国妇幼保健,2014,29(35):5935-5937.