术前空芯针穿刺活检和开放式手术活检对乳腺癌预后影响的比较研究

发布时间：2018-11-26 15:47

【摘要】：目的：探讨乳腺癌患者CNB与OSB相比，其准确性、影响准确性的因素及对预后的影响。方法：回顾性分析吉林大学第一医院1106例行手术治疗的乳腺癌患者的临床病理资料。根据术前诊断方法将其分为CNB组（n=553）和OSB组（n=553）。比较两组间临床病理信息、DFS和OS的差异。所有的统计数据以SPSS软件进行计算和分析。统计学结果以p0.05为差异有统计学意义。卡方检验用于分析计数资料的组间差异（必要时应用Fisher精确检验）。COX比例风险模型用于可能影响乳腺癌患者预后的单因素和多因素分析并以95%为可信区间。结果： CNB诊断符合率为97.6%，病理检出率为89.7%。以下几种情况下，CNB病理诊断的符合率较低：肿物伴有钙化，穿刺病理为导管内癌、导管内癌伴微小浸润和非典型增生。与OSB组相比，CNB未增加患者局部复发率（P=0.363）。活检方式（CNB vs OSB）不作为影响患者DFS（P=0.087，95%CI：0.919~3.448）和OS（P=0.453，95%CI：0.627~2.848）的因素。活检日期-手术日期间的间隔时间也不作为影响患者DFS（P=0.054，95%CI：0.353~1.008）和OS（P=0.223，95%CI：0.397~1.240）的因素。结论：术前空芯针穿刺活检是一种安全可靠的术前诊断方式，值得临床应用与推广。
[Abstract]:Objective: to investigate the accuracy, influencing factors and prognosis of CNB compared with OSB in breast cancer patients. Methods: the clinicopathological data of 1106 patients with breast cancer treated surgically in the first Hospital of Jilin University were analyzed retrospectively. According to the preoperative diagnosis method, the patients were divided into two groups: CNB group (NV 553) and OSB group (n = 553). The differences of clinicopathological information, DFS and OS were compared between the two groups. All statistics are calculated and analyzed by SPSS software. There was a significant difference in the statistical results between the two groups (p 0.05). Chi-square test was used to analyze the differences between groups of counting data (Fisher accurate test of). COX proportional risk model was used for univariate and multivariate analysis of breast cancer patients with 95% confidence interval when necessary. Results: the diagnostic coincidence rate of CNB was 97. 6% and the pathological detection rate was 89. 7%. The coincidence rate of pathological diagnosis of CNB was low: tumor with calcification, biopsy with ductal carcinoma, intraductal carcinoma with microinvasion and atypical hyperplasia. Compared with OSB group, CNB did not increase the local recurrence rate (P0. 363). (CNB vs OSB) was not a factor affecting DFS (P0. 087: 95) and OS (P0. 453 / 95 CI: 0. 627 / 2. 848) of the patient's DFS (P < 0. 087) and OS (P = 0. 453 / 95 CI: 0. 627 / 2. 848). The interval between biopsy date and operation day was also not a factor affecting the patient's DFS (P0.054 / 95) and OS (P0. 22395 CI: 0. 3971.240). Conclusion: preoperative hollow needle biopsy is a safe and reliable preoperative diagnostic method, and it is worthy of clinical application and popularization.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R737.9

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