乳腺癌超声表现与其病理基础的相关性研究  

The correlation between ultrasonographic findings and pathologic features in breast cancers

作　　者：张静雯[1] 周建桥[1] 詹维伟[1] 计静丹[1] 贾懿[1] 费晓春[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院超声科,200025 [2]上海交通大学医学院附属瑞金医院病理科,200025

出　　处：《中华医学超声杂志（电子版）》2011年第6期18-21,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：上海市卫生局青年科研项目资助(项目编号:2008Y110);上海市重点学科建设项目资助(项目编号:S30203)

摘　　要：目的探讨提示肿块为恶性的超声BI-RADS描述术语与相关乳腺癌病理组织学特征的关系。方法 2010年6月至2011年1月我院经病理证实的139例乳腺癌患者的139个肿块,根据超声BI-RADS指标(肿块形态,边缘,边界,内部回声和后方回声),回顾性分析这些指标与相应组织病理学的关系。结果通过肿块形态特征反映肿瘤组织直接浸润周围的灵敏度为97.3%,特异度为14.8%;通过肿块边缘特征反映肿瘤组织浸润周围的灵敏度为99.1%,特异度为18.5%;通过高回声晕反映肿瘤浸润程度,引起间质反应性增生的灵敏度为76.6%,特异度为80.0%;92.8%的肿块内部为低回声,细胞:间质比值会导致肿块内部回声改变(P=0.0126);52.5%的肿块后方回声无改变,30.9%的肿块后方出现声衰减,后方回声特征主要取决于细胞:间质比值(P=0.000)和胶原含量(P=0.000)。结论提示肿块为恶性的超声BI-RADS描述术语与相关乳腺癌病理组织学间存在相关性,超声BI-RADS提供了评估乳腺癌的良好手段。Objective To evaluate the correlation of features favoring malignant described in the ultrasonographic breast imaging reporting and data system （ BI-RADS ） lexicon with the corresponding histopathological features of breast cancer. Methods From June 2010 to January 2011, a total of 139 tumors in 139 patients with pathologically confirmed breast cancer were included and retrospectively analyzed. Ultrasonographic findings were described using features from the uhrasonographic BI-RADS lexicon （ mass shape, margin , lesion bounder, echo pattern, and posterior acoustic features） and analyzed with their corresponding histopathologieal features. Results For reflecting infiltration of carcinoma cells into the surrounding breast tissues, the irregular shape showed a sensitivity of 97.3% and a specificity of 14.8%, as compared with a sensitivity of 99.1% and a specificity of 18.5% without limited margin, while echogenic halo yielded a sen- sitivity of 76.6% and a specificity of 80.0% in predicting tumor cells infiltrated into the adjacent fatty and fibrous tissue with surrounding stromal hyperplasia. Approximately 92.8% of the tumors were hypoechoic, which were mainly determined by the ratio of carcinoma cells to stroma（ P = O. 0126）. Around 52.5% of the tumors revealed no posterior acoustic features and 30.9% demonstrated posterior shadowing, which were as- sociated with both the number of eollagenized fibroblastic stroma （P = 0. 000 ） and the ratio of carcinoma cells to stroma（ P = 0. 000 ）. Conclusion These results demonstrated that there were good correlations between uhrasonographic BI-RADS indicators and histopathological findings. The breast cancer could be assessed by ultrasonographic BI-RADS.

关 键 词：超声检查 病理学 乳腺肿瘤 BI-RADS 

分 类 号：R737.9[医药卫生—肿瘤]