保乳手术与改良根治术对乳腺癌患者并发症及生存预后的影响比较

摘要

目的 探讨保乳手术与改良根治术对乳腺癌患者并发症及生存预后的影响比较.方法 选取2012年12月至2014年12月确诊治疗的乳腺癌患者100例,依据随机分配原则分为保乳组和改良组,每组50例.保乳组患者给予保乳手术治疗,改良组患者给予改良根治术治疗,随访2年,统计分析所有患者术中出血量、手术、住院时间、并发症、生存预后情况和术前术后血清癌胚抗原(CEA)、糖类抗原153(CA153)、转化生长因子-α(TGF-α)、血管内皮生长因子(VEGF)水平.结果 保乳组患者术中出血量、手术、住院时间、并发症发生率明显低于改良组,差异有统计学意义(P＜0.05);保乳组和改良组患者术前术后血清CEA、CA153、TGF-α、VEGF水平基本相同,差异无统计学意义(P＞0.05),但2组患者术后上述指标水平均较术前明显下降,差异有统计学意义(P＜0.05);保乳组患者术后1、2年累积复发率、转移率、生存率高于改良组,但差异无统计学意义(P＞0.05).结论 与改良根治术比较,保乳手术可有效减少乳腺癌患者手术创伤及并发症,且可保留乳房,有利于患者术后恢复,同时对患者血清肿瘤标志物、生存预后改善无不良影响,值得临床作进一步推广.%Objective To investigate and compare the effects of breast conservation surgery and modified radical operation on complication and survival prognosis of patients with breast cancer.Methods One hundred patients with breast cancer who were treated in our hospital from December 2012 to December 2014 were randomly divided into breast conservation group and modified operation group,with 50 patients in each group.The patients in breast conservation group were treated by breast conservation surgery,however,the patients in modified operation group were treated by modified radical operation,following up for two years.Then the intraoperative bleeding volume,surgery time,hospitalization time,complications,postoperative survival prognosis and the changes of serum levels of carcinoembryonic antigen (CEA),carbohydrate antigen 153 (CA153),transforming growth factor alpha (TGF-alpha),vascular endothelial growth factor (VEGF) after operation were observed and compared between two groups.Results The intraoperative bleeding volume,surgery time,hospitalization time,incidence rates of complications in breast conservation group were significantly lower than those in modified operation group (P ＜ 0.05).However there were no significant differences in the serum levels of CEA,CA153,TGF-alpha,VEGF before operation and after operation between breast conservation group and modified operation group (P ＞ 0.05),but these indexes mentioned above were significantly decreased after operation in both groups,as compared with those before operation (P ＜ 0.05).The cumulative relapse rates,metastasis rates and survival rates on 1 y,2y after operation in breast conservation group were higher than those in modified operation group,but there were no significant differences between two groups (P ＞ 0.05),Conclusion As compared with modified radical operation,the breast conservation surgery can effectively decrease surgical trauma and incidence rates of complications of patients with breast cancer,moreover,which can reserve patient's breast and is beneficial to postoperative recovery of patients,without influencing serum tumor markers and survival prognosis of patients,therefor,which is worth using widely in clinical practice.