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外科研究与新技术（中英文）

外科研究与新技术（中英文） ›› 2025, Vol. 14 ›› Issue (1): 61-64.doi: 10.3969/j.issn.2095-378X.2025.01.014

• 论著 • 上一篇    下一篇

保乳联合前哨淋巴结活检手术与改良根治术在早期乳腺癌治疗中的应用价值分析

熊威   

  1. 珠海市第五人民医院普外科,广东 珠海 519055
  • 收稿日期:2024-04-19 出版日期:2025-03-28 发布日期:2025-04-09
  • 作者简介:熊威（1995—），男，学士，住院医师，从事临床普外科工作；电子信箱：wentaoych77@163.com

Values of breast conserving surgery combined with sentinel lymph node biopsy versus modified radical mastectomy in treatment of early breast cancer

XIONG Wei   

  1. Department of General Surgery, Fifth People's Hospital of Zhuhai, Zhuhai 519055, Guangdong, China
  • Received:2024-04-19 Online:2025-03-28 Published:2025-04-09

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摘要： 目的　探讨联合应用保乳和前哨淋巴结活检手术治疗早期乳腺癌的效果,并与乳腺癌改良根治术治疗效果进行比较。方法　选取2021年9月—2023年9月期间收治的早期乳腺癌患者100例,按随机数字表法分为对照组和观察组（各50例）。对照组采用乳腺癌改良根治术,观察组采用保乳联合前哨淋巴结活检手术。比较两组患者围手术期有关指标、并发症发生情况、术后12个月美容满意度和生活质量评分,以及手术后肿瘤标志物[糖类抗原19-9（CA19-9）、癌胚抗原（CEA）及细胞角质蛋白19片段抗原21-1（CYFRA21-1）]水平改善情况。结果　围手术期临床指标比较,观察组术中出血量、引流量少于对照组,观察组手术时间、拔除引流管时间、术后住院时间较对照组缩短,差异均有统计学意义（P<0.05）。观察组并发症发生率低于对照组（P<0.05）。术后12个月美容满意度和生活质量评分比较,观察组均显著高于对照组（P<0.05）。治疗前两组患者CA19-9、CEA及CYFRA21-1水平差异均无统计学意义（P>0.05）,治疗后,两组患者上述肿瘤标志物水平均降低,且观察组较对照组更低（P<0.05）。结论　保乳手术联合前哨淋巴结活检手术治疗早期乳腺癌具有突出作用效果,其不仅疗效与乳腺癌改良根治术接近,还可降低手术并发症风险,且能够有效维持乳房形态,利于术后生活质量提升,患者美容满意度较高,值得推广应用。

关键词: 前哨淋巴结活检术, 改良根治术, 乳腺癌, 生活质量, 安全性

Abstract: Objective To investigate the effect of combination of breast conserving surgery and sentinel lymph node biopsy in the treatment of early breast cancer and compare it with the effect of modified radical mastectomy. Methods A total of 100 cases of early breast cancer admitted from September 2021 to September 2023 were included and divided into 50 cases of control group and 50 cases of observation group by random number table method. The control group underwent modified radical mastectomy, and the observation group underwent breast conserving surgery combined with sentinel lymph node biopsy. Outcome measures included perioperative indicators, incidence of complications, cosmetic satisfaction and quality of life at postoperative 12 months, and postoperative tumor markers [carbohydrate antigen 19-9 （CA19-9）, carcinoembryonic antigen （CEA）, and cytokeratin 19 fragment antigen 21-1 （CYFRA21-1）]. Results Compared with the control group, the intraoperative blood loss and drainage volume were lower, and the operation time, drainage tube removal time, and postoperative hospital stay were shorter in the observation group, and the differences were statistically significant （P<0.05）. The incidence of complications in the observation group was lower than that in the control group （P<0.05）. The observation group showed significantly higher satisfaction with cosmetic results and quality of life scores than the control group （P<0.05）. No differences were found in CA19-9, CEA, and CYFRA21-1 levels between the two groups of patients before treatment （P>0.05）; after treatment, the tumor marker levels in both groups decreased, and the observation group had lower levels than the control group （P<0.05）. Conclusion Breast conserving surgery combined with sentinel lymph node biopsy has a prominent effect in the treatment of early breast cancer patients. The combined surgery is not only close to modified radical mastectomy in terms of effect, but also reduces the risk of surgical complications, effectively maintains breast shape, conducive to improving the quality of life after surgery, and has a high cosmetic satisfaction, which is worthy of promotion and application.

Key words: Sentinel lymph node biopsy, Modified radical surgery, Breast cancer, Quality of life, Safety

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