胸部CT检查在乳腺癌肿瘤影像学评估中的应用价值  

Value of Chest CT on Imaging Examination in Breast Cancer

作　　者：焦霜[1] 李友宏[2] 

机构地区：[1]文山州人民医院放射科,云南文山663000 [2]昆明医科大学第三附属医院放射科,云南昆明650118

出　　处：《昆明医科大学学报》2014年第11期88-91,共4页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81260408);云南省科技厅-昆明医科大学联合专项基金资助项目(2012FB061)

摘　　要：目的 将肿瘤的病理学检查结果作为参考标准,以评估胸部CT检查在预测乳腺癌肿瘤大小方面的应用价值.方法 回顾性分析文山州人民医院180例经手术取材活检证实为浸润性乳腺癌患者术前胸部CT报告的肿瘤大小结果,肿瘤大小以最大肿瘤直径值定义,记录所有患者的胸部CT及病理学检查报告的肿瘤最大直径.通过线性回归及Spearman＆#39;s相关分析对结果进行分析,同时对患者进行亚组分析,根据肿瘤的大小将患者分为肿瘤直径＜20 mm组、肿瘤直径≥20 mm组,根据病理组织学亚型分为浸润性导管癌组、非浸润性导管癌组,并对各亚组之间两种检查结果进行比较分析.结果 在预测肿瘤大小方面,胸部CT与病理学检查结果具有较好的线性相关性（线性回归方程为：病理学肿瘤直径=CT报告肿瘤直径＆#215;1.102-1.136,Spearman＆#39;s相关系数r=0.81,P＜0.001）.纳入对象中绝大部分（n=153,85％）的胸部CT对于肿瘤大小的报告结果与病理学检查结果一致,但有18例患者（10％）肿瘤大小被CT检查低估（平均低估值为11 mm.估值范围：6～36 mm）,9例（5％）被CT检查所高估（平均高估值为10 mm,估值范围：6～19 mm）.亚组分析中,肿瘤＜20 mm组、浸润性导管癌组患者的两种检查结果的吻合率要相应地优于肿瘤≥20 mm组以及非浸润性导管癌组.结论 乳腺癌患者的胸部CT与病理学报告确定的肿瘤大小具有较好的相关性.对于肿瘤＜20 mm、组织学亚型为浸润性导管癌的患者,其胸部CT检查与病理学结果吻合率更好。Objective To eValuate the value of chest CT on predicting breast tumor size using pathology measuremenis as reference standard. Methods Tumor sizes （defined as greatest diameter） were retrospectively measured on the preoperative chest CT images of 180 patients diagnosed with invasive breast carcinoma. Greatest tumor diameters were determined by chest CT and pathologic examinations were compared by linear regression and Spearman＇s rho correlation analysis. Subgroup analysis was also performed according to tumor size （〈 20 mm or ≥ 20 ram） and histological subtype （invasive ductal carcinoma （IDC） or non-IDC） Results There was linear correlation in predicting breast tumor size between CT and pathology measured diameters （size at pathology = 1.102 × CT determined tumor size - 1.136; Spearman＇s correlation coefficient = 0.81, P 〈 0.001） . Most tumors size measured by chest CT （n = 153, 85.0%） were consistent with pathologic examinations, but 18 tumors （10%） were underestimated by CT （average underestimation, 11 ram; range, 6-36 ram） and 9 tumors （5%） were overestimated （average overestimation by CT, 10 ram; range, 6-19 mm） . The concordance rate between the two sets of measurements was greater for tumor of 〈 20 mm and for IDC （P 〈 0.001 and P = 0.011, respectively） than tumor of ≥ 20 mm and for non-IDC. Conclusion Tumor size by chest CT was well correlated with pathology determined tumor size in breast cancer patients. In addition, the concordance rate was even high for breast tumors of 〈 20 mm and for tumors of the IDC histologic subtype.

关 键 词：乳腺癌 胸部CT 肿瘤大小 病理学检查 

分 类 号：R737.9[医药卫生—肿瘤]