Risk factors associated with recurrence of benign breast phyllodes tumors and the feasibility of Mammotome operation
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摘要:
目的 探讨乳腺良性叶状肿瘤术后复发相关危险因素及麦默通手术的可行性。 方法 2007年1月~2016年5月，佛山市妇幼保健院收治乳腺良性叶状肿瘤113例，开放手术扩大切除58例，麦默通旋切手术活检55例，对患者临床及病理资料进行回顾性研究。 结果 开放手术治疗与麦默通微创旋切治疗组间复发率无统计学差异（P>0.05），发病年龄分别为38.8±8.1岁与34.9±8.1岁，肿瘤直径分别为3.6±1.3 cm与2.0±0.7 cm，差异均有统计学意义（P<0.05）。复发组与无复发组间肿瘤大小及核分裂有统计学意义（P<0.05）。但以肿瘤大小分组后, 肿瘤<2.5 cm组术式选择与复发无统计学意义（P=0.67）。 结论 乳腺良性叶状肿瘤患者术后复发与肿瘤病理特征有关，大小<2.5 cm的叶状肿瘤通过麦默通微创旋切治疗是安全可行的。 Abstract:Objective To explore the risk factors associated with recurrence of benign breast phyllodes tumors and the feasibility of Mammotome operation. Methods The clinic and pathological data were retrospectivly analyzed in 113 cases with benign PT who received surgery in the Maternal and Children Healthcare Hospital of Foshan from Jan 2007 to May 2016. There were 58 cases of open surgery and 55 cases of Mammotome surgery. Results The recurrence rate in two groups were not significantly different. The differences of age and tumor size in 2 group were significant.The average age were 38.8±8.1 and 34.9±8.1 years. The average tumor diameter were 3.6±1.3 cm and 2.0±0.7 cm. The differences of tumor size and mitosis in recurrence group and no recurrence group were significant. However, difference of recurrence was not significant between different surgery choice in the small tumor group (P=0.67). Conclusion Recurrence of PT is related to pathological features. Mammotome treatment is safe and feasible when tumor size <2.5 cm. -
Key words:
- benign breast phyllodes tumor /
- clinical characteristics /
- recurrence factors /
- Mammotome
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表 1 患者一般情况（
$\, \overline{{x}}{{±}}{{s}}$ , n）指标 开放手术 微创手术 χ2 P 年龄（岁） 38.8±8.1 34.9±8.1 0.01 <35 20 24 0.995 0.319 ≥35 38 31 肿瘤大小（cm） 3.6±1.3 2.0±0.7 0.000 <2.5 13 43 35.122 0.000 ≥2.5 45 12 核分裂 无 52 53 1.931 0.165 有 6 2 
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表 2 复发分组情况（n）
指标 未复发 复发 χ2 P 年龄（岁） ≤35 39 5 0.764 0.382 >35 57 12 肿瘤大小（cm） ≤2.5 53 3 8.151 0.004 >2.5 43 14 核分裂 无 92 13 8.231 0.004 有 4 4 手术方式 开放手术 49 9 0.021 0.885 微创手术 47 8
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表 3 大小肿瘤组术式与复发情况(n)
肿瘤大小 未复发 复发 χ2 P 肿瘤<2.5 cm 开放手术 12 1 0.182 0.67 微创手术 41 2 肿瘤≥2.5 cm 开放手术 37 8 5.309 0.02 微创手术 6 6
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[1] Zhou ZR, Wang CC, Yang ZZ, et al. Phyllodes tumors of the breast: diagnosis, treatment and prognostic factors related to recurrence[J]. J Thorac Dis, 2016, 8(11): 3361-8. doi: 10.21037/jtd [2] 王 慧, 王 翔, 王成锋. 乳腺叶状肿瘤的临床预后分析[J]. 中华肿瘤杂志, 2015, 37(12): 923-7. doi: 10.3760/cma.j.issn.0253-3766.2015.12.009 [3] 张珊珊, 秦 云, 张轶华, 等. 复发性乳腺叶状肿瘤的临床病理特征分析[J]. 中国实用医药, 2017, 12(8): 90-1. http://d.wanfangdata.com.cn/Periodical/zgsyyy201708041 [4] 贾 翠, 韩邦彩, 何 飞, 等. ER, PR, CD34, P16在乳腺叶状肿瘤中的表达及预后相关性分析[J]. 成都医学院学报, 2016, 11(6): 652-61. http://d.wanfangdata.com.cn/Periodical/chengdyxyxb201606002 [5] Tavassoli F, Devilee P. World Health Organization classification of tumors:pathology & genetics of tumors of the breast and female genital organs[M]. lyon: IARC Press, 2003: 99-103. [6] Muller J. Uber den feineran Ban and die Forman der Krankaften Geschwilste[M]. Berlin: G Reinmer, 1838: 54-7. [7] 龚西騟, 丁华野. 乳腺病理学[M]. 北京: 人民卫生出版社, 2009: 451-3. [8] Moffat CJ, Pinder SE, Dixon AR, et al. Phyllodes tumours of the breast: a clinicopathological review of thirty-two cases[J]. Histopathology, 1995, 27(3): 205-18. doi: 10.1111/his.1995.27.issue-3 [9] Guillot E, Couturaud B, Reyal F, et al. Management of phyllodes breast tumors[J]. Breast J, 2011, 17(2): 129-37. doi: 10.1111/tbj.2011.17.issue-2 [10] Jang JH, Choi MY, Lee SK, et al. Clinicopathologic risk factors for the local recurrence of phyllodes tumors of the breast[J]. Ann Surg Oncol, 2012, 19(8): 2612-7. doi: 10.1245/s10434-012-2307-5 [11] 秦悦农, 陈莉颖, 鲍以嘉. 叶状肿瘤的临床特点及复发因素分析[J]. 实用癌症杂志, 2015, 30(7): 1044-7. http://d.wanfangdata.com.cn/Periodical/syazzz201507031 [12] Sakurai K, Enomoto K, Amano S. Long-term results of surgical therapy for phyllodes tumor of the breast[J]. Gan Kagaku Ryoho, 2010, 37(12): 2784-5. [13] 李晓平, 余绮荷, 黄 晖, 等. 良性与交界性叶状肿瘤局部复发风险的分析[J]. 岭南现代临床外科, 2017, 17(1): 24-6. http://d.wanfangdata.com.cn/Periodical/lnxdlcwk201701006 [14] 骆成玉. 微创时代的乳腺外科-理想与现实的抉择[J]. 中国微创外科杂志, 2014, 14(2): 97-101. [15] Burbank F, Parker SH, Fogarty TJ. Stereotactic breast biopsy: improved tissue harvesting with the Mammotome[J]. Am Surg, 1996, 62(9): 738-44. [16] 李 鑫, 骆成玉, 李海连, 等. 真空辅助微创旋切系统治疗乳腺良性叶状肿瘤的临床研究[J]. 中华乳腺病杂志:电子版, 2016, 10(5): 291-4. http://d.wanfangdata.com.cn/Periodical/zhrxbzz201605008 [17] 王 健, 张丽娜, 顾 林. 麦默通在乳腺良性肿块治疗中的应用研究[J]. 天津医药, 2016, 44(4): 385-8. http://d.wanfangdata.com.cn/Periodical/tjyy201604001 [18] 那将超, 狄长安, 殷咏梅. 麦默通微创旋切术与传统手术治疗乳腺肿块效果对比分析[J].临床和实验医学杂志,2015,14(6):435-8. http://d.wanfangdata.com.cn/Periodical/lchsyyxzz201506002 [19] 贾 翠, 梅 放, 柳剑英, 等. 乳腺叶状肿瘤的分级指标及预后相关因素探讨[J]. 中华病理学杂志, 2017, 46(1): 14-9. http://d.wanfangdata.com.cn/Periodical/zhblx201701004 [20] 马斌林, 耿中利, 单美慧, 等. B超引导下Mammotome微创旋切技术在乳腺良性肿块外科治疗应用研究[J]. 新疆医科大学学报, 2009, 32(7): 839-41. http://d.wanfangdata.com.cn/Periodical/xjykdxxb200907002 [21] Park HL, Kwon SH, Chang SY, et al. Long-Term Follow-Up result of benign phyllodes tumor of the breast diagnosed and excised by Ultrasound-Guided Vacuum-Assisted breast biopsy[J]. J Breast Cancer, 2012, 15(2): 224-9. doi: 10.4048/jbc.2012.15.2.224 -
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