目的探讨在乳腺癌保乳术采用体内标记方法确定的切缘与残癌的关系。方法采用高频彩色超声引导下癌周精确注入亚甲蓝染料后行手术切除,与传统手术方法进行比较,探讨其与切缘残癌阳性有关的其他因素。结果该方法能精确地实施癌块扩大切除,但其切缘阳性率与传统手术无明显差异,切缘残癌阳性仅与HER-2有关。结论超声引导下标记癌块的方法能精确、有效地实施肿块扩大切除术。但切缘与肿块的距离可能与切缘残癌阳性无关。 Objective To investigate the relationship between residual margin and margins identified by in vivo marker in breast conserving surgery. Methods High-frequency color ultrasound was used to guide the accurate injection of methylene blue dye into the perineum and then to be surgically removed. Compared with the traditional surgical methods, other factors related to the positive margins of residual cancer were also discussed. Results The method could accurately expand the tumor mass, but the positive rate of its margins was not significantly different from that of conventional surgery. The positive margins of the residual cancer were only associated with HER-2. Conclusion Ultrasound-guided method of marking the cancer mass can accurately and effectively implement the mass excision. However, the distance between the margin and the tumor may not be related to the positive margin of the residual cancer.