Department of Breast Surgery, Cancer Hospital/Cancer Institute, Fudan University; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Chin Med J (Engl). 2011 May;124(9):1300-4.
Seroma formation is one of the most common complications after breast cancer surgery. Various risk factors have been evaluated for their associations with the development of seromas in Western populations. However, similar data are not available in Chinese series. Therefore, we sought to investigate the potential risk factors for Chinese breast cancer patients.
A prospective study of female breast cancer patients undergoing surgery was carried out in Cancer Hospital of Fudan University, Shanghai, China. Univariate analyses were performed by chi-square test or Student's t test or Mann-Whitney test and multivariate analyses by stepwise Logistic regression. The logistic model included age (years), total serum protein concentration (g/L), drainage volume on postoperative day 3 (POD 3; ml) and time to daily drainage volume not more than 30 ml (TTV30; days).
A total of 158 patients with breast cancer were studied. The mean age at diagnosis was (52.14 ± 10.77) years (range 25 - 92). During the follow-up period, 24 (15.2%) patients developed seromas. Calculated as continuous variables in the stepwise Logistic regression, age (OR = 1.090, 95%CI 1.028 - 1.155, P = 0.004), total serum protein concentration (OR = 0.886, 95%CI 0.791 - 0.992, P = 0.036), drainage volume on POD3 (OR = 1.013, 95%CI 1.002 - 1.023, P = 0.017) and TTV30 (OR = 1.273, 95%CI 1.039 - 1.561, P = 0.020) were independent risk factors for seroma formation. Additionally, significant difference in daily drainage volume was substantiated in the analysis by seroma formation (P = 0.034) rather than by type of surgery (P = 0.713).
Although the pathogenesis of seroma remains controversial, such risk factors as age, nutritional status, drainage volume on POD3 and TTV30 should be considered for prediction and prevention of seroma formation in Chinese breast cancer patients.
血清肿形成是乳腺癌手术后最常见的并发症之一。已经评估了各种危险因素与西方人群中血清肿发展的相关性。然而，中国系列中没有类似的数据。因此，我们试图研究中国乳腺癌患者的潜在危险因素。
在中国上海复旦大学附属肿瘤医院对接受手术的女性乳腺癌患者进行了一项前瞻性研究。采用卡方检验或学生 t 检验或曼-惠特尼检验进行单因素分析，采用逐步逻辑回归进行多因素分析。逻辑模型包括年龄（岁）、总血清蛋白浓度（g/L）、术后第 3 天引流量（POD3；ml）和每日引流量不超过 30ml 的时间（TTV30；天）。
共研究了 158 例乳腺癌患者。诊断时的平均年龄为（52.14±10.77）岁（范围 25-92）。在随访期间，24 例（15.2%）患者发生了血清肿。在逐步逻辑回归中作为连续变量计算，年龄（OR=1.090，95%CI 1.028-1.155，P=0.004）、总血清蛋白浓度（OR=0.886，95%CI 0.791-0.992，P=0.036）、POD3 引流量（OR=1.013，95%CI 1.002-1.023，P=0.017）和 TTV30（OR=1.273，95%CI 1.039-1.561，P=0.020）是血清肿形成的独立危险因素。此外，在血清肿形成的分析中证实了每日引流量的差异有统计学意义（P=0.034），而不是手术类型（P=0.713）。
尽管血清肿的发病机制仍存在争议，但应考虑年龄、营养状况、POD3 引流量和 TTV30 等危险因素，以预测和预防中国乳腺癌患者的血清肿形成。
