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Updated: Jan 29, 2026

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新辅助化疗后的残留微化:对外科手术决策的含义 - - 一项系统性审查
Yun Yeong Kim1, Hyun Jik Kim1, Yong Soon Chun1
1Department of General Surgery, Breast Cancer Center, Gachon University Gil Medical Center, Incheon 21565, Republic of Korea.
Journal of clinical medicine
|January 28, 2026
概括
乳腺癌新辅助化疗 (NAC) 后的残留微化通常是良性或局部的,而不是侵入性疾病. 这表明基于病理反应的个性化手术,而不仅仅是成像发现.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 病理学 病理学 病理学
背景情况:
- 乳腺癌中新辅助化疗 (NAC) 后残留微化的意义尚不清楚.
- 传统上,这些被视为恶性瘤的指标,但许多可能是良性或局部变化.
- 本综述阐明了NAC.后持续化的影响.
研究的目的:
- 系统地审查乳腺癌中NAC后残留化的诊断,病理和瘤影响.
- 评估这些化的预后相关性.
- 为 NAC.治疗的乳腺癌患者进行手术规划提供信息.
主要方法:
- 在主要数据库 (PubMed,Embase等) 中按照PRISMA 2020指南进行系统的文献搜索. 从2000年1月到2025年5月.
- 包括的研究集中在接受NAC的成人乳腺癌患者,其残留化和现有的基因病理学或生存数据.
- 数据提取和质量评估由两位审查员独立进行.
主要成果:
- 分析了24项涉及3000多名患者的研究.
- 35-55%的残留化是良性的;其他的是管道癌 in situ,而不是侵入性癌症.
- 在病理完整反应 (pCR) 后持续的化并没有持续地恶化存活率,并且在某些情况下导致过度治疗.
结论:
- 在NAC后的残留化并不是残留侵入性疾病的确切指标,也不是完全外科切除的强制性原因.
- 它们的频繁良性/in situ性质和有限的预后价值支持个性化手术规划.
- 在手术决策中,优先考虑病理反应和边缘状态,而不是仅仅是放射性化.
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