【摘要】 目的 探讨适合中国女性保乳手术的切除范围，提出规范化治疗标准。方法 对68例乳腺癌全乳腺切除标本采用常规病理、免疫组化及分子生物学方法，检测癌和癌旁不同范围组织增殖细胞核抗原(proliferation cell nuclear antigen,PCNA)、P53、C-erbB-2等表达情况。结果 随距原发癌越远，癌旁发生高危病变、PCNA、C-erbB-2及P53阳性的比例逐渐降低。EIC(+)、C-erbB-2或P53阳性者，癌旁危险因素阳性的范围广；而癌旁危险因素阳性范围与年龄、肿瘤大小、腋淋巴结受累情况、ER/PR状况、PCNA表达无关(P>0.05)。结论 Ⅰ、Ⅱ期乳腺癌保乳术后复发危险因素绝大多数(95.2%)在瘤缘外2cm以内存在，因此推荐以癌旁2cm作为保乳手术的安全切除范围，远离乳头端可缩小手术范围至癌旁1cm处；原发癌C-erbB-2扩增和P53突变时，行保乳手术应适当扩大切除范围(>2cm)；EIC(+)时，应扩大手术范围。

    【关键词】 乳腺癌；保乳手术；P53；增殖细胞核抗原；C-erbB-2

    Clinical and pathological study about the excision volume of breast-conserving operation for breast cancer

    ZHUANG Yong-zhi,WU Yun-fei,ZHANG Run-zhi.

    Center for Tumor Therapy,Daqing Oilfield General Hospital,Daqing 163001,China

    【Abstract】 Objective To research the excision volume that adapt to Chinese women in breast-conserving therapy (BCT) and to provide a standard rule of therapy in BCT.Methods 68 specimens of mammary exsected due to breast cancer were tested by method of immunohistochemistry,pathology and molecularbiology to detect the expression of PCNA,P53,C-erbB-2 in tumor and around tumor.Results With the distance to tumor increased,the expression of PCNA,P53,C-erbB-2 decreased.The range of risk factors around tumor was relative to EIC(+),P53(+),C-erbB-2(+),but not relative to age,tumor size,the expression of PCNA,the status of ER/PR and the status of lymphonodus.Conclusion Most risk factors appear in 2cm to tumor in stage Ⅰ and Ⅱ breast cancer patients,so we recommend 2cm to tumor as the safe exsection standard.The range of exsection should be expanded(>2cm)when there were P53 mutation,the expression of C-erB-2 expanded and EIC(+). ......