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目的探讨I,II期乳腺癌部分腋窝淋巴结清扫术对乳腺癌患者的预后及上肢功能的影响。方法随机选择临床I,II期乳腺癌部分腋窝淋巴结清扫组(PAL)及全腋窝淋巴结清扫组(TAL)各1 1 0例。PAL组行乳腺癌改良根治术加部分腋窝淋巴结(I,II组淋巴结)清扫术,TAL组行乳腺癌改良根治术加全腋窝淋巴结清扫术。比较术后远期复发及上肢功能状况。结果随访5~1 0年,PAL组胸部局部复发4例,占3.8%(4/1 0 6),腋窝淋巴结复发转移1例;TAL组胸部局部复发5例,占4.9%(5/1 0 3),无腋窝淋巴结复发转移;两组差异无显著性(P>0.0 5)。PAL组发生患肢水肿及功能障碍5例,占4.7%(5/1 0 6);TAL组1 2例,占1 1.7%(1 2/1 0 3),差异有极显著性(P<0.01)。两组5年和1 0年生存率均无明显统计学差异。结论I,II期乳腺癌实施使PAL可减少患肢的术后功能障碍,不增加预后风险。
Objective To investigate the effect of partial axillary lymph node dissection in patients with stage I and II breast cancer on prognosis and upper limb function. Methods One hundred and ten cases of clinical stage I and II breast cancer were randomly selected from the group of axillary lymph node dissection (PAL) and total axillary lymph node dissection (TAL). PAL group underwent modified radical mastectomy plus partial axillary lymph node dissection (group I, II lymph node dissection), TAL group underwent modified radical mastectomy plus full axillary lymph node dissection. Postoperative long-term recurrence and upper limb functional status were compared. Results In the 5 to 10 years follow-up, 4 cases (3.8%) had local chest recurrence in PAL group and 1 case had axillary lymph node metastasis (5 cases) 3), no recurrence and metastasis of axillary lymph nodes; no significant difference between the two groups (P> 0.0 5). In PAL group, 5 cases (4.7%) had limb edema and dysfunction, 12 cases (11.2%) in TAL group had significant difference (P < 0.01). There was no significant difference in the 5-year and 10-year survival rates between the two groups. Conclusion The implementation of stage I and II breast cancer can reduce the postoperative dysfunction of limbs without increasing the risk of prognosis.