钙化和无钙化乳腺导管原位癌超声及组织病理学特征差异分析  

Calcified and non-calcified ductal carcinoma in situ differences in sonographic and pathologic features

作　　者：李胜利[1] 陈琮瑛[1] 袁鹰[1] 郑琼[1] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院超声科,深圳518028

出　　处：《中华超声影像学杂志》2016年第6期506-509,共4页Chinese Journal of Ultrasonography

基　　金：深圳市医学科研基金项目（201202083）

摘　　要：目的：比较影像学检查有钙化和无钙化的乳腺导管原位癌（DCIS）在超声表现、组织病理学特征方面的差异。方法选择经手术病理证实为单纯性乳腺 DCIS 患者82例,共计83个病灶（1例为双侧病变）为研究对象。根据钼靶 X 线检查结果,将83个病灶分为钙化组和无钙化组,运用χ2检验对两组乳腺 DCIS 的超声表现及组织病理学特征进行对比分析。结果（1）钙化组超声检查阳性发现率为80%（44/55）,最常见超声表现为非肿块异常（436%,24/55）,仅表现为单纯导管扩张9个（164%,9/55）；无钙化组超声检查阳性发现率为964%（27/28）,最常见超声表现为肿块（892%,25/28）,仅表现为单纯导管扩张2个（71%,2/28）。两组肿块的超声特征在形态、边界、方向、后方回声方面差异无统计学意义（P 〉005）,而在直径、边缘、内部回声特征方面差异有统计学意义（P 〈005）；（2）组织病理学对比分析,钙化组中高级别 DCIS、雌激素受体、孕激素受体、Ki67、Her-2的表达较无钙化组常见。结论钙化和无钙化乳腺 DCIS 有不同的超声表现及组织病理学特征。钙化 DCIS 较无钙化 DCIS 更有侵袭性。Objective To compare the sonographic and pathologic features of calcified and non-calcified ductal carcinoma in situ DCIS Methods A total of 83 lesions in 82 consecutive patients with pathologically confirmed pure DCIS were recruited One patient had bilateral lesions All lesions were divided into calcified DCIS and non-calcified DCIS according to the presence of calcifications on mammography Their sonographic features and pathologic reports for all patients with DCIS were retrospectively reviewed Statistical comparisons were performed using the chi-square test Results 1 Calcified DCIS showed positive ultrasound US findings in 80% 44 55 of cases The most common US finding was nonmass lesions 43 6% 24 55 Nine cases had pure ductal dilatations 16 4% 9 55 Non-calcified DCIS showed positive US findings in 96 4% 27 28 of cases The most common US finding was mass 89 2% 25 28 Two cases had pure ductal dilatations 7 1 % 2 28 No significant difference was found in the shape margin orientation posterior feature of a mass between the calcified and non-calcified groups P 〉0 05 Significant difference was observed in the size boundary echogenicity on ultrasound of the two groups P 〈0 05 2 At histopathology the pathological scores high nuclear grade positive ER status positive PR status positive Ki67 status and the presence of Her-2 neu oncogene were more common in the calcified group than in the non-calcified group Conclusions Calcified and non-calcified pure DCIS have different pathologic and sonographic features Calcified DCIS has more aggressive histological features than non-calcified DCIS.

关 键 词：超声检查 乳腺肿瘤 钙化 

分 类 号：R737.9[医药卫生—肿瘤]