乳腺恶性叶状肿瘤的临床与超声特征研究  

Study of the clinical and sonographic features of malignant breast phyllodes tumor

作　　者：孝梦甦[1] 朱庆莉[1] 姜玉新[1] 戴晴[1] 李建初[1] 游珊珊[1] 张璟[1] 刘赫[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院超声诊断科,100730

出　　处：《中华医学超声杂志（电子版）》2012年第12期49-53,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金(30570529);首都十大危险疾病科技成果推广项目(Z111107066411016)

摘　　要：目的研究乳腺恶性叶状肿瘤(MPT)临床、超声声像图表现及其病理特征,为恶性叶状肿瘤诊断提供依据。方法对手术病理证实的12例恶性叶状肿瘤患者的临床、超声声像图表现、病理形态学特征、肿瘤复发转移与临床预后进行总结分析。结果 12例恶性叶状肿瘤患者超声声像图表现:肿瘤大小及部位:12例患者13个恶性叶状肿瘤位于左侧乳腺4例,右侧乳腺8例,其中8个肿瘤最大径≥5.0cm,5个肿瘤<5.0cm。肿瘤形态及边界:13个恶性叶状肿瘤10个呈分叶状,2个形态不规则;11个边界清晰,2个边界不清晰。内部回声及后方回声:11个内部回声不均匀,2个内部回声均匀;9个后方回声增强,6个内部伴无回声。内部钙化:1个肿瘤内出现粗大钙化,12个内部无钙化。血流分级:彩色多普勒血流成像示2个肿瘤表现为Ⅰ级血流,3个表现为Ⅱ级血流,8个表现为Ⅲ级血流。第1次手术方式:12例患者中6例采用单纯肿瘤切除活检术,2例采用肿瘤扩大切除术,4例采用乳房切除术。术后临床随访结果:术后随访20～155个月,平均(69.9±46.4)个月,其中4例肿瘤局部复发(1例复发1次,1例复发2次,1例复发3次,1例复发15次,3例第1次手术为肿瘤单纯切除术,1例第1次手术为全乳切除术),1例出现肺部转移。结论肿瘤体积较大,呈实性分叶状,内部回声不均伴无回声,血流丰富,易局部复发为乳腺恶性叶状肿瘤的临床超声表现。Objective To investigate the clinical and sonographic features of malignant phyllodes tumor（MPT） of the breast.Methods Twelve patients with pathologically diagnosed MPT who had operations in our hospital were followed up.The clinical,sonographic,pathological features and prognosis of MPT were analyzed.Results The characteristics of the 12 patients with MPT were as follows：tumor size and location：12 patients had 13 MPT.MPT located in left and right breast were in 4 and 8 patients,respectively.Eight tumors with a maximum diameter≥5.0 cm,while 5 tumors were 〈5.0 cm.Sonographic features：MPT manifested as lobulation in 10 tumors,irregular shape in 2 tumors;well-defined margin in 11 tumors,indistinct margin in 2 tumors;heterogeneity in 9 tumors,posterior acoustic enhancement in 9 tumors,internal anechoic area in 6 tumors,coarse calcification in 1 tumor;level Ⅰ blood flow in 2 tumors,level Ⅱ blood flow in 3 tumors,and level Ⅲ blood flow in 8 tumors.Type of the first surgery：A total of 6 patients were treated by local excision,2 patients by wide excision and 4 patients by mastectomy.Follow-up results：Mean follow-up of the 12 patients were（69.9±46.4） months（ranged 20-155 months）,with local recurrence in 4 patients（3 patients taken local excision,1 patient taken mastectomy;1 patient relapsed for once,1 patient relapsed for twice,1 relapsed for 3 times and 1 for 15 times）.One patient had lung metastases.Conclusion The clinical and sonographic features of MPT were a large,lobulated,heterogeneous tumor with cystic area,rich blood flow and high recurrence rate.

关 键 词：超声检查 乳腺肿瘤 叶状瘤 

分 类 号：R737.9[医药卫生—肿瘤]