摘要目的 比较前哨淋巴结活检阳性的Ⅰ～Ⅱ期乳腺癌患者保乳手术后行腋窝淋巴清扫术和腋窝局部放疗法的复发率和生存率,确定两种治疗方式的疗效.方法 回顾性分析2010年1月-2015年7月榆林市第一医院收治的137例前哨淋巴结活检阳性的Ⅰ～Ⅱ期乳腺癌患者,保乳手术后行腋窝淋巴结清扫术(ALND)的患者归为ALND组(n=92),保乳手术后行腋窝局部放疗(RNI)的患者归为RNI组(n=45),比较两组患者的一般临床特征(平均年龄、绝经人数、临床分期等)和预后情况(2年复发率、远处转移率、累积2年无事件生存率、累积2年生存率).计量资料以均数±标准差((x)±s)表示,组间比较采用t检验;计数资料以率(％)表示,组间比较采用x2检验.结果 两组患者一般临床特征(平均年龄、绝经人数、临床分期等)差异无统计学意义,对于Ⅰ～Ⅱ期前哨淋巴结阳性乳腺癌患者,ALND组与RNI组的2年复发率(分别为4.4％、6.7％,P =0.87)、远处转移率(分别为9.7％、15.6％,P=0.48)、累积2年无事件生存率(分别为85.9％、75.6％,P=0.14)和累积2年总生存率(分别为90.2％、86.7％,P=0.53)差异均无统计学意义.结论 对于Ⅰ～Ⅱ期前哨淋巴结阳性乳腺癌患者,腋窝RNI或许可以成为替代ALPD的新疗法.

abstractsObjective To compare the recurrence rate and survival rate of axillary lymphadenectomy and axillary local radiotherapy after breast-conserving surgery in patients with stage Ⅰ-Ⅱ breast cancer who were positive for sentinel lymph node biopsy.Methods A retrospective analysis of 137 patients with stage Ⅰ-Ⅱ breast cancer who were positive for sentinel lymph node biopsy from January 2010 to July 2015 in Yulin First Hospital was performed.Patients underwent axillary lymph node dissection (ALND) after breast-conserving surgery were assigned to the ALND group (n =92),patients with axillary local radiotherapy (RNI) after breast-conserving surgery were assigned to the RNI group (n =45),and the general clinical characteristics (mean age,menopause,clinical stage,etc.) were compared between the two groups,and prognosis (2-year recurrence rate,distant metastasis rate,cumulative 2-year event-free survival,cumulative 2-year overall survival).Measurement data were expressed as ((x) ± s),and t test was used for comparison between groups;count data was expressed as rate (％),and chi-square test was used for comparison between groups.Results There were no statistical differences in general clinical characteristics (mean age,menopausal number,clinical stage,etc.) between the two groups.For patients with stage Ⅰ-Ⅱ sentinel lymph node-positive adenocarcinoma,breast-conserving surgery plus axillary lymph node dissection (ALND group) and breast-conserving 2-year recurrence rate (4.4％,6.7％,P =0.87)and distant metastasis rate (9.7％,15.6％,P =0.48) and cumulative 2 years of surgery plus axillary local radiotherapy (RNI group) There were no statistically significant differences in event-free survival (85.9％,75.6％,P =0.14) and cumulative 2-year overall survival (90.2％,86.7％,P =0.53).Conclusion For patients with stage Ⅰ-Ⅱ sentinel-positive breast cancer,axillary RNI may be a new treatment for ALND.