Effect of Operation Incision Selection on Success rate of Sentinel Lymph Node Biopsy and Subcutaneous Hydrops in Breast Cancer
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摘要:目的
探讨不同手术切口对乳腺癌行前哨淋巴结活检成功率及皮下积液发生情况的影响。
方法回顾分析2011—2013年南昌市第三医院乳腺一科收治的乳腺癌病例，依条件排除后共132例入组。69例行乳房加腋窝横行双切口手术，63例行乳房延伸至腋窝单切口手术。比较两种手术切口方式下前哨淋巴结的检出率、患者切口引流时间以及皮下积液发生率的差异。
结果单切口组与双切口组，前哨淋巴结检出率分别为96.8%与97.1%，差异无统计学意义（P>0.05）。当前哨淋巴结为阴性时，双切口组与单切口组患者术后切口引流时间比较，差异无统计学意义（P>0.05）；当前哨淋巴结为阳性时，双切口组与单切口组患者术后切口引流时间比较，差异有统计学意义（P＜0.05）；当前哨淋巴结为阴性时，双切口组患者腋下积液发生率为23.8%，单切口组为7.5%，差异有统计学意义（P＜0.05）；当前哨淋巴结为阳性时，双切口组患者腋下积液发生率为28.0%，单切口组为23.8%，两组比较差异有统计学意义（P＜0.05）。
结论术前腋窝淋巴结评估为阴性的患者选择单切口将更有利于降低患者术后皮下积液的发生率且引流时间短于双切口组，而术前腋窝淋巴结评估为阳性的患者两种手术切口方式在术后皮下积液的发生率以及带管时间上未见差异。
Abstract:ObjectiveTo investigate the effect of operation incision selection on the success rate of sentinel lymph node biopsy and subcutaneous hydrops in breast cancer.
MethodsA retrospective analysis of 132 cases of breast cancer were enrolled from the Third Hospital of Nanchang from 2011 to 2013. Sixty-nine cases received breast plus axillary incision surgery, and 63 cases received breast extended to axillary incision surgery. The detection rate of sentinel lymph nodes, incision drainage time and the incidence of subcutaneous effusion were compared between both groups.
ResultsThe successful rate of sentinel lymph node detection in single incision group and double incision group were 96.8% and 97.1%, respectively(P>0.05). When the sentinel lymph nodes were negative, the difference of drainage time between two groups had no statistical significance (P>0.05), the incidence of axillary hydrops of double incision group and single incision group were 23.8% and 7.5% (P<0.05); while when the sentinel lymph nodes were positive, the difference of drainage time between two groups had statistical significance (P<0.05). The incidence of axillary hydrops between two groups were 28.0% and 23.8% (P<0.05).
ConclusionPreoperative axillary lymph node assessment is helpful for negative patients to select single incision, which is beneficial to reduce the incidence of postoperative subcutaneous effusion and drainage time in comparison with double incision group. As for positive patients, preoperative axillary lymph node assessment has no effect on the incidence of postoperative subcutaneous effusion or the time of tube between two types of surgical incision.
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Key words:
- Operation incision /
- Breast cancer /
- Sentinel lymph node biopsy /
- Subcutaneous hydrops
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图 1 乳房加腋窝横行双切口前哨淋巴结活检及术后效果图
Figure 1 Sentinel lymph node biopsy of breast plus axillary transverse double incision and postoperative effect
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[1] Soteldo J, Ratto EL, Gandini S, et al. Pelvic sentinel lymph node biopsy in melanoma patients: is it worthwhile?[J]. Melanoma Res, 2010, 20(2): 133-7. doi: 10.1097/CMR.0b013e3283324e40
[1] Soteldo J, Ratto EL, Gandini S, et al. Pelvic sentinel lymph node biopsy in melanoma patients: is it worthwhile?[J]. Melanoma Res, 20 10, 20(2): 133-7. [2] Krag DN, Anderson SJ, Julian TB, et al. Sentinel-lymph-noderesection compared with conventional axillary 1ymph-nodedissection in clinically node-negative patients with breast cancer: overall smvival findings from the NSABP B-32 randomised phase3 trial[J]. Lancet Oncol, 2010, 11(2): 927-33．
[2] Krag DN, Anderson SJ, Julian TB, et al. Sentinel-lymphnoderesection compared with conventional axillary 1ymphnodedissection in clinically node-negative patients with breast cancer: overall smvival findings from the NSABP B-32 randomised phase3 trial[J]. Lancet Oncol, 2010, 11(2): 927-33. [3] Aoyama K, Kamio T, Ohchi T, et al. Sentinel lymph node biopsy for breast eancer patients using fluorescence navigation with indocyanine green[J]. World J Surg Oncol, 2011, 9: 157. [3] Aoyama K, Kamio T, Ohchi T, et al. Sentinel lymph node biopsy for breast eancer patients using fluorescence navigation with indocyanine green[J]. World J Surg Oncol, 2011, 9: 157. doi: 10.1186/1477-7819-9-157
[4] Yang R,Wang SJ, Zhang Y, et al. Progress and prospect of methylene blue as lymph tracer[J]. Zhongguo Yao Ji Xue Za Zhi, 20 09, 7(2): 65-71. [杨瑞, 王淑君, 张颖, 等. 亚甲蓝作为淋巴示 踪剂的研究与展望[J]. 中国药剂学杂志, 2009, 7(2): 65-71.] [4] 杨瑞, 王淑君, 张颖, 等. 亚甲蓝作为淋巴示踪剂的研究与展望[J]. 中国药剂学杂志, 2009, 7(2): 65-71. http://www.cnki.com.cn/Article/CJFDTOTAL-PZGY200902006.htm Yang R,Wang SJ, Zhang Y, et al. Progress and prospect of methylene blue as lymph tracer[J]. Zhongguo Yao Ji Xue Za Zhi, 2009, 7(2): 65-71. http://www.cnki.com.cn/Article/CJFDTOTAL-PZGY200902006.htm
[5] Howell A, Anderson AS, Clarke RB, et al. Risk determination and prevention of breast cancer[J]. Breast Cancer Res, 2014, 16(5): 446. [5] Howell A, Anderson AS, Clarke RB, et al. Risk determination and prevention of breast cancer[J]. Breast Cancer Res, 2014, 16(5): 446. doi: 10.1186/s13058-014-0446-2
[6] Ni XJ, Zhang XL, Ou-Yang QW, et al. An elevated peripheral blood lymphocyte-to-monocyte ratio predicts favorable response and prognosis in locally advanced breast cancer following neoadjuvant chemotherapy[J]. PLoS One, 2014, 9(11): e111886. doi: 10.1371/journal.pone.0111886
[6] Ni XJ, Zhang XL, Ou-Yang QW, et al. An elevated peripheral blood lymphocyte-to-monocyte ratio predicts favorable response and prognosis in locally advanced breast cancer following neoadjuvant chemotherapy[J]. PLoS One, 2014, 9(11): e111886. [7] Yang J, Li HJ, Yang XQ, et al. Relationship of prediction of breast cancer infiltrating lymphocytes responsing to neoadjuvant chemotherapy and prognosis[J]. Huaxi Yi Xue, 2015, 30(6): 1179-82. [杨菁, 李宏江, 羊晓勤, 等. 乳腺癌浸润淋巴细胞对新辅助化学疗 法反应的预测及与预后的关系[J]. 华西医学, 2015, 30(6): 1179-82.] [7] 杨菁, 李宏江, 羊晓勤, 等. 乳腺癌浸润淋巴细胞对新辅助化学疗法反应的预测及与预后的关系[J]. 华西医学, 2015, 30(6): 1179-82. http://www.cnki.com.cn/Article/CJFDTOTAL-HXYX201506055.htm Yang J, Li HJ, Yang XQ, et al. Relationship of prediction of breast cancer infiltrating lymphocytes responsing to neoadjuvant chemotherapy and prognosis[J]. Huaxi Yi Xue, 2015, 30(6): 1179-82. http://www.cnki.com.cn/Article/CJFDTOTAL-HXYX201506055.htm
[8] Pettersson A, Graff RE, Ursin G, et al. Mammographic density phenotypes and risk of breast cancer: a meta-analysis[J]. J Natl Cancer Inst, 2014, 106(5): pii: dju078. [8] Pettersson A, Graff RE, Ursin G, et al. Mammographic density phenotypes and risk of breast cancer: a meta-analysis[J]. J Natl Cancer Inst, 2014, 106(5): pii: dju078. doi: 10.1093/jnci/dju078
[9] Haddad TC, Goetz MP. Landscape of neoadjuvant therapy for breast cancer[J]. Ann Surg Oncol, 2015, 22(5): 1408-15. doi: 10.1245/s10434-015-4405-7
[9] Haddad TC, Goetz MP. Landscape of neoadjuvant therapy for breast cancer[J]. Ann Surg Oncol, 2015, 22(5): 1408-15. [10] Chen X, Wang S. Current status andadvancer of sentinel lymph node biopsy in breast cancer[J]. Zhongguo Pu Wai Ji Chu Yu Lin Chuang Za Zhi, 2011,18(1): 98-102. [陈翔, 王水. 乳腺癌前哨淋巴结活检研 究现状及进展[J]. 中国普外基础与临床杂志, 2011, 18(1): 98-102.] [10] 陈翔, 王水. 乳腺癌前哨淋巴结活检研究现状及进展[J]. 中国普外基础与临床杂志, 2011, 18(1): 98-102. http://www.cnki.com.cn/Article/CJFDTOTAL-ZPWL201101038.htm Chen X, Wang S. Current status andadvancer of sentinel lymph node biopsy in breast cancer[J]. Zhongguo Pu Wai Ji Chu Yu Lin Chuang Za Zhi, 2011,18(1): 98-102. http://www.cnki.com.cn/Article/CJFDTOTAL-ZPWL201101038.htm
[11] Wang S, Fan P, Wu ZY. Preliminary study on lymphocyte subests of sentinel lymph nodes in breast cancer patients[J]. Zhonghua Zhong Liu Za Zhi, 2010, 26(4): 220-2. [王水, 范萍, 武正炎. 乳腺癌前哨淋巴 结淋巴细胞亚群的初步研究[J]. 中华肿瘤杂志, 2010, 26(4): 220-2.] [11] 王水, 范萍, 武正炎. 乳腺癌前哨淋巴结淋巴细胞亚群的初步研究[J]. 中华肿瘤杂志, 2010, 26(4): 220-2. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHZL200404009.htm Wang S, Fan P, Wu ZY. Preliminary study on lymphocyte subests of sentinel lymph nodes in breast cancer patients[J]. Zhonghua Zhong Liu Za Zhi, 2010, 26(4): 220-2. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHZL200404009.htm
[12] Creager AJ, Geisinger KR. Int raoperative evaluation of sentinel lymph nodes for breast carcinoma: current methodologies[J]. Adv Anat Pathol, 2010, 9(4): 233-43. [12] Creager AJ, Geisinger KR. Int raoperative evaluation of sentinel lymph nodes for breast carcinoma: current methodologies[J]. Adv Anat Pathol, 2010, 9(4): 233-43. http://cn.bing.com/academic/profile?id=2028989906&encoded=0&v=paper_preview&mkt=zh-cn
[13] Ma HY, Progression on minimally invasive therapy of breast cancer[J]. Zhonghua Pu Wai Ji Chu Yu Lin Chuang Za Zhi, 2010, 17 (3): 214-8. [马宏岩. 乳腺癌微创治疗的研究进展[J]. 中华普 外基础与临床杂志, 2010, 17(3): 214-8.] [13] 马宏岩. 乳腺癌微创治疗的研究进展[J]. 中华普外基础与临床杂志, 2010, 17(3): 214-8. http://www.cnki.com.cn/Article/CJFDTOTAL-ZPWL201003003.htm Ma HY, Progression on minimally invasive therapy of breast cancer[J]. Zhonghua Pu Wai Ji Chu Yu Lin Chuang Za Zhi, 2010, 17(3): 214-8. http://www.cnki.com.cn/Article/CJFDTOTAL-ZPWL201003003.htm
[14] Wu SD, Fan Y, Xi W, et al. Single incision breast conservation surgery and cavity mirror the axillary lymph node resection in 2 cases[J]. Zhonghua Ru Xian Bing Za Zhi(Dian Zi Ban), 2010, 4(5): 62-3. [吴 硕东, 范莹, 希渥, 等. 单切口乳腺癌保留乳房手术并腔镜下腋窝 淋巴结切除术2例[J]. 中华乳腺病杂志(电子版), 2010, 4(5): 62-3.] [14] 吴硕东, 范莹, 希渥, 等. 单切口乳腺癌保留乳房手术并腔镜下腋窝淋巴结切除术2例[J]. 中华乳腺病杂志(电子版), 2010, 4(5): 62-3. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHRD201005019.htm Wu SD, Fan Y, Xi W, et al. Single incision breast conservation surgery and cavity mirror the axillary lymph node resection in 2 cases[J]. Zhonghua Ru Xian Bing Za Zhi(Dian Zi Ban), 2010, 4(5): 62-3. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHRD201005019.htm
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