摘要
目的分析乳腺叶状肿瘤的局部复发的临床风险因素。方法使用SAS Cox s风险比例因素回归模型分析1956年1月至2008年12月,24所医院的505例叶状肿瘤各种临床因素与局部复发的关系。结果发病中位年龄41岁（11-74岁）,良性302例、交界性130例、恶性73例;术式包括肿物单纯切除术、扩大切除和单纯或根治性乳房切除术;局部复发143例,因瘤死亡27例。分析显示局部复发与病理组织学分级、术式选择、术中是否使用冰冻和疗效评价四个临床因素有统计学意义。结论当前叶状肿瘤外科治疗所用术式中,治疗不足（肿瘤单纯切除术式、复发后的交界性和恶性采用肿瘤扩大切除术式）是术后局部复发的重要因素,复发率为54.39%;良性肿瘤采用扩大切除术,局部复发率为1.94%（2/103例）,交界性肿瘤首选肿瘤扩大切除术的局部复发率为11.11%（3/27例）,恶性肿瘤首选乳房切除术的局部复发率12.50%,具有良好的治疗作用。术中应用冰冻切片诊断是抑制局部复发的重要因素,使局部复发率由37.66%减低为13.66%（P〈0.0 001）。
Objective To better identify hazard factors for local recurrence and survival, as well as the role of different surgery patterns with rare phyllodes tumors of the breast. Methods and Materials To analyze clinical outcome of different surgery patterns on 505 patients with phyllodes tumors of breast by Cox＇s proportional hazard regression model according to the requests of SAS. 505 patients collected from 24 hospitals were treated from 1956 to 2008. The median age of the patients was 38. 63 （range from 11 to 74） . Tumors were benign in 302 cases, borderline in 130 cases, and malignant in 73 cases. The surgeries consisted of simple tylectomy in 217 eases, wide local excision in 154 eases and mastectomy in 144 cases. Results Local recurrence rates were 28.32% （ 143/505 cases） . Cox＇s analysis revealed estimate for surgery treatments, histotypes of phyllodes tumor, surgery patterns, and frozen section were favorable factors for local recurrence. Conclusions This study shows that patients with benign tumors have a good prognosis after wide local excision.
出处
《辽宁医学院学报》
CAS
2009年第4期310-313,共4页
Journal of Liaoning Medical University (LNMU) Bimonthly
关键词
乳房
叶状肿瘤
外科
术式
局部复发
breast
phyllodes tumor
recurrence
surgery patterns
