前哨淋巴结活检术在乳腺癌手术中的应用

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目的探讨乳腺癌手术治疗中前哨淋巴结活检术的应用价值。方法选取2013年2月至2016年12月间海南省中医院收治的80例接受乳腺癌手术治疗的患者,采用随机数表法分为观察组(接受前哨淋巴结活检术)与对照组(未接受前哨淋巴结活检术),每组40例。比较两组患者治疗前后血清肿瘤标志物水平和不良反应情况。结果治疗后观察组患者血清肿瘤标志物癌脴抗原(CEA)、糖类抗原(CA153)和糖类抗原(CA125)分别为(2.36±0.56)ng/ml、(13.21±5.53)U/ml和(15.64±5.43)U/ml,对照组患者分别为(3.28±0.86)ng/ml、(14.86±4.53)U/ml和(16.98±6.69)U/ml,两组均较治疗前明显降低,且观察组患者较对照组降低更多,差异均有统计学意义(均P<0.05)。对照组患者皮下积液、上肢水肿和上肢活动受限等并发症发生率合计为40.0%,观察组患者为7.5%,两组比较,差异有统计学意义(P<0.05)。结论前哨淋巴结活检辅助乳腺癌手术能够避免不必要的淋巴结清扫,减少机体损伤,降低不良反应发生率,且不会对手术效果造成影响,可在临床中推广。 Objective To investigate the value of sentinel lymph node biopsy in surgical treatment of breast cancer. Methods Eighty patients undergoing breast cancer surgery admitted from Hainan Provincial Hospital of Traditional Chinese Medicine from February 2013 to December 2016 were randomly divided into observation group (receiving sentinel lymph node biopsy) and control group (not receiving Sentinel lymph node biopsy), 40 cases in each group. Serum tumor marker levels and adverse reactions were compared between the two groups before and after treatment. Results After treatment, the levels of CEA, CA153 and CA125 in the observation group were (2.36 ± 0.56) ng / ml, (13.21 ± 5.53) U / ml and (15.64 ± 5.43) U / ml in the control group and (3.28 ± 0.86) ng / ml, (14.86 ± 4.53) U / ml and (16.98 ± 6.69) U / ml in the control group respectively. The patients in observation group had more reduction than those in control group (all P <0.05). In the control group, the complication rates of subcutaneous fluid, upper extremity edema and upper extremity activity were 40.0% in the control group and 7.5% in the observation group. The difference between the two groups was statistically significant (P <0.05). Conclusion Sentinel lymph node biopsy assisted breast cancer surgery can avoid unnecessary lymph node dissection, reduce body damage, reduce the incidence of adverse reactions, and will not affect the surgical results, can be promoted in the clinic.
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