保乳手术治疗早期乳腺癌的疗效及miR-21和miR-155表达的研究

]目的观察保乳手术对早期乳腺癌的远期治疗效果，并检测组织中miR-21和miR-155的表达，探讨其临床意义。方法选择124例早期乳腺癌患者作为研究对象，采用保乳手术为主的综合治疗62例，列为观察组，采用乳腺改良根治手术治疗62例，列为对照组。观察两组治疗方式的远期效果。术后组织应用实时荧光定量PCR法（qRT-PCR）检测观察组中miR-21和miR-155的表达，分析其临床意义。结果两组患者3年和5年随访生存率无明显差别(P>0.05)。观察组随访生活质量评分明显高于对照组(P<0.05)，差异有统计学意义。观察组中miR-21和miR-155在不同组织学分级、脉管癌栓及有无坏死、钙化的分组的表达中差异有统计学意义(P<0.05)。观察组5年内复发患者miR-21和miR-155的表达明显高于非复发患者(P<0.05)。生存分析显示miR-21和miR-155的表达与生存时间相关(P<0.05)。结论早期乳腺癌患者应用保乳手术进行治疗，临床效果明显，患者生活质量高。术后检测miR-21和miR-155的表达对判断预后可能具有一定价值。

Efficacy of early breast cancer by breast-conserving surgery and expression study of miR-21 and miR-155

ObjectiveTo observe the long-term therapeutic effect of early breast cancer by breast conserving surgery, and to detect the expressions of microRNA-21 and microRNA-155, to explore their clinical significance. Methods124 cases of early breast cancer were divided into two groups. The observation group(62 cases) was treated by breast conserving surgery. The control group(62 cases) was treated by modified radical mastectomy. Long-term effect was observed in two groups. The expressions of miR-21 and miR-155 were detected by real-time fluorescence quantitative PCR in the observation group, and their clinical significance was analyzed. ResultsThe 3-year and 5-year follow-up survival rates has no not statistical significant in two groups (P>0.05). The quality of life score was significantly higher in the observation group than that in the control group (P<0.05). The expressions of miR-21 and miR-155 were different in histological grade, vascular cancer thrombus, necrosis and calcification in the observation group (P<0.05). The expressions of miR-21 and miR-155 were related with recurrence in the observation group (P<0.05). Expression of miR-21 and miRA-155 was correlated with survival time (P<0.05). ConclusionBreast-conserving surgery can improve clinical effect, increase life quality in patients of early breast cancer. Expression of miR-21 and miR-155 may be important value in judging prognosis.