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目的 探讨乳腺癌根治或改良根治术后腋窝淋巴结清扫和检测的彻底程度对预后的影响和对放射治疗的指导意义。方法 回顾性分析 2 11例乳腺癌接受根治性手术治疗、术后合并或不合并化疗 +放射治疗的病例。根据腋窝淋巴结清扫和检测个数分为 2个组 ,A组 81例 (腋窝淋巴结个数 <10个 ) ,B组 130例 (腋窝淋巴结个数≥ 10个 )。观察 2个组的局部区域复发率和生存率有无显著性差异。结果 A组和B组淋巴结转移数≥ 4个的病例分别占 2 1.0 %和 35 .4% (P =0 .0 2 6 )。A组和B组局部区域复发率分别为 33.3 %和 2 0 .8% (P =0 .0 42 )。淋巴结阴性和转移数为 1～ 3个的局部区域复发率A组为 2 9.7% ,B组为 15 .5 % ,差别有显著性意义 (P =0 .0 37)。A组腋窝淋巴结阴性及淋巴结阳性患者的远地转移率分别为 16 .7%和 31.6 % (P =0 .16 9) ,5年无瘤生存率分别为 6 2 .5 %和 45 .6 % (P =0 .2 5 3) ,5年总生存率分别为 70 .8%和 5 7.9% (P =0 .2 5 3) ,差异均无显著性意义。B组淋巴结阴性及淋巴结阳性患者的远地转移率分别为 5 .9%和 38.0 % (P =0 .0 0 0 ) ,5年无瘤生存率分别为 82 .4%和 5 0 .6 % (P =0 .0 0 0 ) ,5年总生存率分别为 92 .2 %和 6 3 .3% (P =0 .0 0 0 ) ,差异均有显著性意义。结论 腋窝淋巴结清扫和?
Objective To investigate the effect of the thoroughness of axillary lymph node dissection and detection after radical or modified radical mastectomy on the prognosis and the significance of radiation therapy. Methods Retrospective analysis of 21 cases of breast cancer undergoing radical surgery, postoperative or non-chemotherapy+radiotherapy. According to the number of axillary lymph node dissections and the number of tests, they were divided into two groups: 81 cases in A group (<10 axillary lymph nodes) and 130 cases in B group (≥10 axillary lymph nodes). Observe whether there is a significant difference between the recurrence rate and survival rate in the two groups. Results The number of cases with lymph node metastasis ≥ 4 in group A and group B accounted for 21.0 % and 35.4%, respectively (P = 0.026). The recurrence rates in the local area of group A and group B were 33.3% and 20.8%, respectively (P = 0.042). The regional recurrence rate of lymph node-negative and metastatic number 1 to 3 was 29.7% in group A and 15.5% in group B, with significant difference (P=0.037). The distant metastasis rate in the axillary node-negative and lymph node-positive patients in group A was 16.7% and 31.6%, respectively (P =0.16 9). The 5-year disease-free survival rates were 6 2.5% and 45.6%, respectively. (P = 0.253), the 5-year overall survival rate was 70.8% and 5 7.9% (P = 0.253), with no significant difference. The distant metastases in group B lymph node-negative and lymph node-positive patients were 5.9% and 38.0%, respectively (P =0. 0 0 0). The 5-year disease-free survival rates were 82.4% and 50.6%, respectively. (P =0. 0 0 0), the 5-year overall survival rate was 92.2% and 63. 3% (P =0. 0 0 0 ), respectively. The differences were significant. Conclusion Axillary lymph node dissection and