目的

探讨乳腺癌手术创面脱落癌细胞的相关因素及防范对策。

方法

对174 例乳腺癌术后的腋下和肿瘤附近创面引流液作脱落细胞涂片检查，将结果与相关因素作对比分析。

结果

本组脱落癌细胞阳性者42例，占24% 。 T1和T2差异有统计学意义（ P =0.008，χ² =6.960），T2和T3～4差异有统计学意义（P=0.000，χ²=26.372）。 Ⅰ期和Ⅱ、Ⅲ、Ⅳ期比较差异有统计学意义（P =0.000，χ²=33.187），Ⅱ期和Ⅲ、Ⅳ期比较差异有统计学意义（P =0.000，χ² =18.200），Ⅲ期和Ⅳ期比较差异无统计学意义（P =0.471，χ²=0.520）。 有淋巴结转移和无淋巴结转移比较差异有统计学意义（P=0.000，χ²=18.748）；非浸润和浸润比较差异有统计学意义（P=0.004，χ²=8.121）；根治和改良根治比较差异无统计学意义（P =0.059，χ² =3.563）；腋下引流和胸创面比较差异有统计学意义（P =0.004，χ²=8.116）。

结论

脱落癌细胞阳性率与肿瘤大小、病期早晚、组织学类型和有无淋巴结转移有关，提高手术操作质量可降低脱落癌细胞阳性率。

Objective

To study the relative factors about exfoliative cytology of operative wound and to provide theory for reducing exfoliative tumor cell in the operation.

Methods

Examination of drained liquid of the axilla and the wound around tumor was done in 174 patients with breast tumor.The relative action amony exfoliated cells， size，clinical classification of tumor and lymphmetastasis of axilla was analyzed.

Results

In 174 patients，exfoliated tumor cells were found in 42 patients （24% ）.There was significant difference（P=0.008，χ²=6.960） between T1 and T2.There was significant difference（P =0.000， χ²=26.372）between T2 and T3-4.There was significant difference（P=0.000， χ²=33.187） between Ⅰand Ⅱ，Ⅲ，Ⅳ stage.There was significant difference（ P =0.000， χ²=18.200） between Ⅱand Ⅲ，Ⅳstage.There wasnt significant difference （P =0.471， χ² =0.520） between Ⅲ and Ⅳ stage.There was significant difference（P=0.000， χ²=18.748） between patients with of without lymphmetastasis.There was significant difference（P =0.004， χ²=8.121） between infiltrative carcinoma and noninfiltrative carcinoma.There wasnt significant difference （P =0.059， χ² =3.563） between operation of Patey and Halsted.There was significant difference（P =0.004， χ² =8.116） between wound of axilla and operation.

Conclusions

Exfoliated tumor cells is related to size，stage，type and lymphmetastasis of tumor.It is necessary to improve operation for reducing positive rate of exfoliative tumor cells.