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題 名 | 乳癌病患腋下淋巴轉移分佈狀態之分析 |
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作 者 | 王德錦; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 24:5 民80.09-10 |
頁 次 | 頁835-840 |
分類號 | 416.226 |
關鍵詞 | 乳癌; 腋下淋巴轉移; |
語 文 | 中文(Chinese) |
中文摘要 | 對168例在馬偕醫院接受完全腋下淋巴廓清(complete axillary dissection by Level)的乳癌病患為對象分析評估,發現94例(56%)有腋下淋巴轉移現象。168例所有淋巴節廓清數目共有3055個,每位病患平均淋巴廓清數目為18.2個,分佈於Level I的淋巴節數目平均13.2個(72.6%);Level II的平均2.8個(15.5%);Level III平均2.2 個(11.9%)。94例服下淋巴轉移病患,只有Level I轉移者54例(57.4%);Level I +Level II轉移者24例(25.5%);Level I + II +III都有轉移者9例(9.6%),可見以上87例(92.5%),其腋下淋巴的轉移方式都是階段性、規則性的按順序由Level I,II然後再轉移至Level III,只有7例 7.5%)不按理,具跳級性的轉移(skip metastasis)。若Level I沒有淋巴轉移時,會有Level II或Level III淋巴轉移之機會幾乎等於零;反之若在Level I有淋巴轉移時,會轉移到Level II或Level III的機會約為43.3%,而且Level I之positive lymphnodes有4個以上時,會轉移至Level II或Level III的機會約為60.7%。由本篇分析結論,作者認為完全腋下廓清對乳癌之治療及預後評估是非常重要而不可缺的程序。 |
英文摘要 | One hundred and sixty-eight patients with carcinoma of the breast treated with the complete axillary dissection by level were evaluated. Ninetyfour patients (56%) had lymph nodes metastases in axillary specimens. The clinical and pathologic stage was determined and compared for all patients. Among patients judged to have a clinical negative axilla, 42% had histologically positive lymph nodes (clinical falsenegative rate). For patients with a clinical positive axilla, 8.5% had histologically negative lymph nodes (clinical false positive rate). The total number of lymph nodes removed among 168 patients was 3055, with an average of 18.2 nodes per patients. The average number of nodes at level I was 13.2, at the level II 2.8, and at the level III 2.2. Among the 94 cases with positive axillary lymph nodes, 54 cases (54.4%) showed the level I involved only, 24 cases (25.5%) metastases were present at levels I and II, where in 9 cases (9.6%), all three levels were sites of metastases. Only 7 cases (7.5%) showed skipping distribution with level II was skipped. We concluded from our findings that when the nodes of the first level are clear, the chances that metastastic nodes are present at the levels II or/and III are negligible, whereas the nodes at the level I are positive, the chances that metastases are also present at the higher level are 43.3%. Therefore, a complete axillary dissection including three levels should be berformed, which will provide an accurate assessment of axillary lymph node status and represent an important aspect of the management of patients with the operable breast cancer. |
本系統中英文摘要資訊取自各篇刊載內容。