乳腺导管内癌的X线表现与组织病理学、分子分型的对照研究  

Control study of X-ray appearances and histopathology,molecule subtype of breast ductal carcinoma in situ

作　　者：陈卫国[1] 徐维敏[1] 文婵娟[1] 赵亮[2] 周大菊[1] 叶华秀[1] 廖昕[1] 

机构地区：[1]南方医科大学南方医院放射科,广东广州510515 [2]南方医科大学南方医院病理科,广东广州510515

出　　处：《中国医学影像技术》2014年第8期1211-1215,共5页Chinese Journal of Medical Imaging Technology

基　　金：广东省产学研结合重点项目课题(2011A090200056);广东省科技计划项目(2012A032200011)

摘　　要：目的探讨乳腺导管内癌(DCIS)的X线表现与组织级别、分子分型及Ki-67的关系。方法回顾性分析133例136侧DCIS的X线表现及组织病理学、免疫组织化学结果。结果 1136侧DCIS低级别19侧、中级别9侧、高级别108侧;低、中级别X线多表现为单纯钙化(10/28,35.71%),高级别为钙化伴局灶性不对称/肿块(38/108,35.19%)。2136侧DCIS中,Luminal A型70侧(70/136,51.47%)、Luminal B型17侧(17/136,12.50%)、Her-2过表达型41侧(41/136,30.15%)及三阴性型8侧(8/136,5.88%);除Her-2过表达型多以钙化伴局灶性不对称/肿块(17/41,41.46%)为主要表现外,Luminal A型(23/70,32.86%)、Luminal B型(8/17,47.06%)及三阴性型(4/8,50.00%)均以单纯钙化多见,差异无统计学意义(χ2=17.408,P=0.135)。3ER/PR(+)钙化形态多为细小多形性(35/51,68.63%)、成簇分布(27/51,52.94%);ER/PR(-)多为线样分支状(19/33,57.58%)、段样分布(23/33,69.70%)。Her-2过表达钙化形态多为线样分支状(20/38,52.63%)、段样分布(25/38,65.79%);Her-2(-)多为细小多形性(33/46,71.74%)、成簇分布(24/46,52.17%),差异有统计学意义(P均<0.05)。4Ki-67≤10%时,钙化形态多为细小多形性(15/17,88.24%);当Ki-67>30%时,钙化形态多为线样分支状(14/29,48.28%),差异有统计学意义(χ2=10.776,P=0.029)。结论 DCIS X线以钙化为主要表现,钙化的形态、分布在一定程度上可反映组织级别及ER/PR、Her-2、Ki-67的表达情况。Objective To explore the relationship of the X-ray appearances and histopathology,molecule subtype,proliferation index of the Ki-67 of the breast ductal carcinoma in situ（DCIS）.Methods The X-ray appearances,histopathology and immunhistochemistry of the 133 cases DCIS（all 136lateral-breast）were retrospectively analyzed.Results The 136 laterals DCIS included low-grade 19 laterals,intermediate-grade 9laterals and high-grade 108 laterals.The main X-ray appearance of the low-and intermediate-grade DCIS were calcification（10/28,35.71%）,while the high-grade was calcification with focal dissymmetry/mass（38/108,35.19%）.2All cases included the Luminal A 70laterals（70/136,51.47%）,Luminal B 17laterals（17/136,12.50%）,Her-2-overexpress 41laterals（41/136,30.15%）and triple-receptors negative8laterals（8/136,5.88%）.The main X-ray appearance of the Her-2-overexpress was calcification with focal dissymmetry/mass（17/41,41.46%）,the other molecule subtypes were purely calcifications.There was no statistical significance in the main X-ray appearance of different molecule subtypes（χ^2=17.408,P=0.135）.3The ER/PR（＋）cases of main appearance of the calcifications were fine pleomorphic（35/51,68.63%）,cluttered（27/51,52.94%）,while the ER/PR（-）cases were linear branching（19/33,57.58%）,segment（23/33,69.70%）;the Her-2（＋）cases were linear branching（20/38,52.63%）,segment（25/38,65.79%）,while the Her-2（-）cases were fine pleomorphic（33/46,71.74%）,cluttered（24/46,52.17%）.There was statistical significance in the main appearance of the calcifications of them（all P〈0.05）.4When the proliferation index of the Ki-67≤10%,the main morphous of the calcifications was fine pleomorphic（15/17,88.24%）,while the proliferation index of the Ki-67〉30%,it was found linear branching（14/29,48.28%;χ^2=10.776,P=0.029）.Conclusion The main X-ray appearance of the DCIS is calcifications.The morphous,distrutions of the calcifications may reflect the ER,PR,Her-2and the

关 键 词：乳腺肿瘤 乳房X线摄影术 病理学 分子分型 

分 类 号：R737.9[医药卫生—肿瘤] R445[医药卫生—临床医学]