目的 探究保乳术(BCS)治疗早期乳腺癌(EBC)患者的效果及对创伤后应激障碍(PTSD)发生、预后的影响。方法 选取我院90例EBC患者(2020年1月～2021年2月),随机分成A组(n=45)、B组(n=45)。B组接受乳腺癌改良根治术(MRM)治疗,A组接受BCS治疗。对比2组手术指标、应激障碍筛查量表(PCL-C)评分及阳性率、手术前后血清胸苷激酶1(TK1)、糖类抗原153(CAl53)、组织多肽特异性抗原(TPS)、癌胚抗原(CEA)水平、乳房外观优良率、并发症发生率。结果 A组切口长度、手术及住院耗时较B组短,术后引流量及术中失血量较B组低(P＜0.05)；A组PCL-C评分较B组低,PTSD阳性率较B组低(P＜0.05)；2组术后3个月血清TK1、CAl53、TPS、CEA水平均较术前降低(P＜0.05),但A组与B组相比,无明显差异(P＞0.05)；A组乳房外观优良率较B组高(P＜0.05)；A组并发症发生率较B组低(P＜0.05)。结论 应用BCS或MRM治疗EBC患者均能有效调节血清TK1、CAl53、TPS、CEA水平,抑制肿瘤进展,效果相当,但前者于优化手术指标、提高乳房外观优良率、降低PTSD及并发症发生风险方面更具优势,对改善患者预后具有积极意义。

Objective To explore the effect of breast conserving surgery (BCS) in the treatment of patients with early breast cancer (EBC) and its influence on the occurrence and prognosis of post-traumatic stress disorder (PTSD). Methods Ninety patients with EBC in our hospital (from January 2020 to February 2021) were randomly divided into group A (n=45) and group B (n=45). Group B received modified radical mastectomy (MRM) and group A received BCS. Surgical indicators, Stress disorder Screening Scale (PCL-C) score and positive rate, serum thymidine kinase 1 (TK1), carbohydrate antigen 153 (CAl53), tissue polypeptide-specific antigen (TPS), carcinoembryonic antigen (CEA) levels before and after surgery, breast appearance good rate, incidence of complications were compared between the two groups. Results The incision length, operation and hospitalization time in group A were shorter than those in group B, and the postoperative drainage volume and intraoperative blood loss were lower than those in group B (P < 0.05). The PCL-C score of group A was lower than that of group B, and the positive rate of PTSD was lower than that of group B (P < 0.05). Serum levels of TK1, CAl53, TPS and CEA in 2 groups were decreased 3 months after surgery (P < 0.05), but there was no significant difference between group A and group B (P > 0.05). The good and good rate of breast appearance in group A was higher than that in group B (P < 0.05). The complication rate of group A was lower than that of group B (P < 0.05). Conclusion The use of BCS or MRM in the treatment of EBC patients can effectively regulate the levels of serum TK1, CAl53, TPS and CEA, and inhibit tumor progression, with similar effects, but the former has more advantages in optimizing surgical indicators, improving the rate of breast appearance, reducing the risk of PTSD and complications, and has positive significance in improving the prognosis of patients.