保乳术个体化组织切除范围指征的探讨

目的：建立可以在乳癌保乳术中预测术后局部复发可能的Logistic模型.方法：回顾性研究乳癌根治性手术病例515例,以肿瘤存在广泛浸润的相关因素作为自变量,应用统计软件SPSS11.5中Logistic回归法,分别对乳腺癌瘤体周边2cm以外的乳房内部组织和瘤床所在的皮肤、皮下组织两部位,建立预测存在肿瘤广泛浸润的Logistic模型.再以已知的病例资料为测试样本,验证模型的有效性.结果：建立的Logistic模型,预测乳房内部组织肿瘤广泛浸润的特异度为80.43%,灵敏度为73.46%,符合率为78.61%;预测皮肤、皮下组织肿瘤广泛浸润的特异度为84.34%,灵敏度为80.95%,符合率为83.96%.结论：建立的Logistic模型在保乳术病例中预测术后皮肤、皮下组织复发结果理想,有临床应用价值.

The analysis about the indication of breast-conserving surogery for individually removal range of tissue

Objective: To seek an objective criterion evaluating fatalness of local recurrence on breast cancer in the operation. Methods: Retrospectively study 515 cases following radical mastectomy provided datum. A series of available prognostic factors of local recurrence were analysed. The patients treated with modified radical mastectomy were adopted as researchful swatch, on the assumption that all of them had performed with breast-conserving surgery instead of modified radical mastectomy. The datum were tested by statistics software SSPS11.5.The prognostic Logistic model of local recurrence was achieved by the parameters turned up among the predict factors , and were used check up some foregone patients with breast mastectomy. Results: The relative factors of local recurrence were regarded as independent variable parameters to achieve the prognostic logistic model to estimate the probability of local recurrence on breast cancer. The outcome of predicting local recurrence inside the out-layer mammary superficial fascia : veracity=78.61%; sensitivity=73.46%; differentiability=80.43%, outside: veracity=83.96%; sensitivity=80.95%; differentiability=84.34%.Conclusion: Depending on the Logistic model, the probability of local recurrence on breast-conserving surgery was achieved efficiently.