乳腺叶状囊肉瘤40例临床研究.docVIP

乳腺叶状囊肉瘤40例临床研究[摘要] 目的 通过对本院 40 例乳腺恶性叶状肿瘤的回顾性分析，总结乳腺恶性叶状肿瘤的诊断、临床特点和治疗经验，强调外科手术对其治疗的重要意义。 方法 全部患者给予手术+术后辅助放射治疗。 结果 40例患者中，有16例（40%） 曾误诊为乳腺纤维瘤或巨纤维瘤，局部扩大切除术12例，全乳切除术22例，全乳切除并腋窝淋巴结清扫术6例（术后病理提示腋窝淋巴结转移3例），局部复发3例，死亡1例。随访 2～10 年，5 年生存率为97.5%。 结论 乳腺恶性叶状肿瘤的诊断主要依据病理学检查，对可疑患者应行术前穿刺活检，术中冷冻切片检查。手术是治疗为本病的主要治疗方法。叶状囊肉瘤预后与肿瘤的组织学分级，肿瘤大小和手术切除是否彻底有关。 [关键词] 乳腺恶性叶状肿瘤；临床分析；手术治疗；临床分析 [中图分类号] R737.9 [文献标识码] B [文章编号] 1674-4721（2012）07（c）-0224-03 Clinical analysis of 40 patients with malignant phyllodes tumor ZHOU Tao MO Junyang▲ HUANG Ping ZHUANG Yaqiang ZHU Qiyi Department of Breast Thyroid Surgery, the Fifth Hospital of Guangxi Medical University, Liuzhou 545006，China [Abstract] Objective Through a retrospective analysis of 40 cases of breast malignant phyllodes tumor, to summary breast malignant phyllodes tumor diagnosis, clinical features and treatment experience, and emphasized the significance of surgical treatment. Methods All patients were given surgery plus postoperative adjuvant radiotherapy. Results In 40 cases, 16 cases (40%) was misdiagnosed as a breast fibroma or giant fibroma of the local extensive resection of 12 cases, 22 cases mastectomy, total mastectomy and axillary lymph node dissection was performed in 6 cases (the pathological tipsaxillary lymph node metastasis in 3 cases), 3 cases of local recurrence and 1 cases died. Followed up for 2 to 10 years, the 5-year survival rate was 97.5%. Conclusion Diagnosis of breast malignant phyllodes tumor based on pathological examination of biopsy for suspicious patients with preoperative, intraoperative frozen section examination. Surgery is the treatment of disease-oriented treatment. Phyllodes prognosis and tumor histological grade, tumor size and surgical resection is completely relevant. [Key words] Breast malignant phyllodes tumor; Clinical analysis; Surgical treatment; Clinical analysis 乳腺叶状囊肉瘤（cystsarcoma，phyllodes，CP）是一种双相分化的肿瘤，由良性的上皮成分和间叶成分组成，是一种少见的纤维上皮性肿瘤，占乳腺肿瘤的0.3%～0.9%，占乳腺纤维上皮性肿瘤的2.5%。又称乳腺恶性叶状肿瘤（PT）。临床少见，发