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目的 :评价保乳手术+放疗与改良根治术在乳腺导管内癌(DCIS)患者中的治疗效果及与抑癌基因PTEN、凋亡抑制蛋白Survivin的变化关系。方法 :连续选择我院DCIS患者中50例选择保乳手术+放疗,50例选择改良根治术,比较术后1年PTEN和Survivin的表达水平,1年和3年的局部肿瘤复发率和转移率的差异性。结果 :1.术前两组患者的PTEN和Survivin的表达阳性率比较,差异无统计学意义;1年后保乳手术+放疗组PTEN表达上调,Survivin表达下调,差异有统计学意义,改良根治术组变化不大,组间比较差异有统计学意义。2.两组的1年和3年的局部肿瘤复发率比较,差异无统计学意义,1年的转移率比较,差异无统计学意义,保乳手术+放疗组的3年转移率显著低于改良根治术组,差异有统计学意义。结论 :严格掌握手术适应症,保乳手术+放疗治疗DCIS的效果不劣于改良根治术,降低转移率的机制可能与上调PTEN、下调Survivin的表达有关。
Objective: To evaluate the therapeutic effect of breast conserving surgery combined with radiotherapy and modified radical mastectomy on the expression of PTEN and Survivin in patients with ductal intraductal carcinoma (DCIS). Methods: Forty DCIS patients in our hospital were selected for continuous breast-conserving surgery and radiotherapy. Fifty patients underwent modified radical mastectomy. The expression of PTEN and Survivin at 1 year and 1 year and 3 years of local tumor recurrence and metastasis The difference. The positive expression rates of PTEN and Survivin in the two groups of patients before surgery were not statistically different. One year later, the expression of PTEN and the expression of Survivin were up-regulated in breast-conserving surgery and radiotherapy group, the difference was statistically significant The operation group changed little, the difference between the two groups was statistically significant. There was no significant difference in the recurrence rates of local tumors between the two groups at 1 year and 3 years. There was no significant difference in 1-year metastasis rates between the 2 groups. The 3-year metastasis rate of breast conserving surgery + radiotherapy group was significantly lower than Modified radical mastectomy, the difference was statistically significant. CONCLUSIONS: Strict control of surgical indications, breast-conserving surgery + radiotherapy is not inferior to modified radical mastectomy and the mechanism of reducing metastasis may be related to up-regulation of PTEN and down-regulation of Survivin expression.