乳腺癌手术创面脱落癌细胞的临床研究

目的探讨乳腺癌手术创面脱落癌细胞与临床病理分期的关系,为术中采用杀灭脱落癌细胞的措施提供理论依据。方法对１０９例乳腺癌患者手术创面冲洗液进行细胞学检查,并将其中１０４例的结果与临床病理结果做对比分析。结果本组１０４例患者,脱落癌细胞阳性者３６例,占３４．６％。Ⅰ期、Ⅱ期及Ⅲ期乳腺癌患者手术创面脱落癌细胞检出率分别为３．８％、２９．８％和８５．７％。Ｔ１、Ｔ２和Ｔ３以上癌细胞检出率依次为１０．８％、３３．３％和７７．３％。腋淋巴结转移数目４枚以上者手术创面脱落癌细胞阳性率为７６．０％,而无腋淋巴结转移者仅１３．５％。结论乳腺癌手术结束时,采用杀灭或去除手术创面脱落癌细胞的措施,是必要的。

Exfoliative cancer cells in the surgical field of breast cancer

OBJECTIVE: To study the relationship between exfoliative cancer cells in the surgical field and pathological stages of breast cancer and provide a theoretical basis for killing or removing of the exfoliative cancer cells in the surgical field. METHOD: Cytological examination of surgical field washings was performed in 104 patients with breast cancer. The results and pathological stages were compared and analysed. RESULT: Exfoliative cancer cells were found in the surgical field washings in 36 of 104 (34.6%). Stage I, II and III showed a positive rate of 3.8%, 29.8% and 85.7%. The positive rate of T(1), T(2) and beyond T(3) were 10.8%, 33.3% and 77.3%, respectively. When the number of axillary metastatic lymph nodes was over four, the positive rate of exfoliative cancer cell was 76.0% and only 13.5% if no axillary lymph node metastasis. CONCLUSION: Killing or removing of the exfoliative cancer cells in the surgical field of breast cancer is necessary.