乳腺浸润性导管癌穿刺活检标本与术后标本病理分级之间的相关性研究  

Correlation of Tumor Grade Between Biopsies and Surgical Excisions of Invasive Ductal Breast Carcinoma

作　　者：齐荣秀[1] 赵浙民[1] 韦永南[1] 劳美新[1] 廖源[1] 黄子安[1] 

机构地区：[1]广州中医药大学附属南海区妇幼保健院放射科,广东佛山528000

出　　处：《现代医用影像学》2014年第1期6-8,共3页Modern Medical Imageology

基　　金：2013年佛山市卫生局立项课题;编号284

摘　　要：目的:探讨乳腺浸润性导管癌钼靶引导下核芯针穿刺活检标本与术后标本病理分级之间的相关性。材料与方法:130例乳腺浸润性导管癌患者行钼靶引导下穿刺活检,将活检标本与根治术后标本的病理分级进行比较,对其中107例标本的雌激素及孕激素受体表达的一致性亦进行比较。肿瘤分级使用改良Scarff-Bloom-Richardson分级方法。结果:核芯针穿刺活检和手术病理分级之间总的一致率为75%,Kappa值为0.57;穿刺活检为1级的准确率为53.3%(8/15),2级的准确率为69.5%(57/82),3级的准确率为100%(33/33)。核芯针穿刺活检低估率为21%(27/130),高估率为3.8%(5/130)。核芯针穿刺活检标本和手术切除标本ER、PR受体表达之间的一致率分别为88.8%(95/107),86%(92/107)。结论:钼靶引导下穿刺活检标本与术后标本病理分级之间总体具有较好的一致性,其标本的ER、PR免疫组化染色结果亦比较可靠。Purpose： To assess the concordance between tumor grade determined by nmmmography-guided core biop- sies of invasive ductal breast carcinomas and subsequent excision specimens. Materials and Methods： A total of 130 patients diagnosed with invasive ductal breast carcinoma by mammography-guided core biopsy who underwent radical mastecto- my were enrolled in this retrospective study. The correlation of tumor grade between biopsies and surgieal excisions specimens was evaluated. The correlation of estrogen/progesterone receptor was also evaluated. Tumor grade was assigned using the standard modified Seafff-Bloom-Richardson system. Results： Overall, there was a 75% agreement between biopsy and surgi- cal excision（Kappa ： 0. 57）. Agreement by grade found on biopsy was 53. 3% （8/15） for grade 1,69. 5% （57/82） for grade 2, and 100% （33/33） for grade 3 lesions. The grade was higher in the biopsy than in the surgical excision in 5 cases （3. 8% ）, and lower in 27 cases （2l % ）. The concordance rate between biopsy and surgical excision was 88. 8% （95/ 107 ） for ER and 86% （92/107） for PR. Conclusion ： There is a reasonable level of agreement between core biopsy and sur- gical excision for pathological grading. Core biopsy can reliably be used for assessment of ER and PR immunostaining.

关 键 词：乳腺癌 肿瘤分级 乳腺钼靶摄影 穿刺活检 

分 类 号：R737.9[医药卫生—肿瘤]