乳腺导管原位癌及浸润癌超声表现与病理相关性新探  

New Exploration of the Correlation between Sonographic and Pathological Features of Ductal Carcinoma in Situ and Invasive Ductal Carcinoma

作　　者：王心怡[1] 张楠[1] 秦王燕[1] 常洪晶 何英剑[1] 廖盛日[1] 霍苓[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所乳腺中心恶性肿瘤发病机制及转化研究教育部重点实验室,北京市100142

出　　处：《中国超声医学杂志》2017年第6期498-500,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的比较乳腺导管原位癌(DCIS)与浸润性导管癌(IDC)超声表现的差异,探讨超声对DCIS的诊断价值。方法回顾性总结145个穿刺病理为DCIS的病例,其中88个得到术后病理证实,57个为IDC伴DCIS;抽取同一时间段300个IDC病例,比较三类病变声像图差异,分析DCIS病理分级与超声表现的关系。结果三组平均最大径、后方回声、伴微小钙化及乳导管扩张的比例有显著差异,IDC与DCIS组差异较大,而穿刺病理低估组的超声表现介于二者之间。DCIS组表现为结构紊乱区26个(29.5%)、占位性病变62个(70.5%)。高级别DCIS平均最大径及伴微小钙化的比例更高。结论 DCIS由低到高级别、由原位癌进展为浸润癌在超声表现中是递进的。近1/3的DCIS没有占位效应,临床工作中应提高警惕。Objective To investigate the diagnostic value of ultrasonography in breast ductal carcinoma （DCIS） by comparing the sonographic findings of DCIS and invasive ductal carcinoma （IDC）. Methods A total of 145 pathologically-determined DCIS lesions were reviewed after biopsy, of which 57 were shown to be IDC co-existing with DCIS after surgery. The sonographic features of 88 pure DCIS, 57 IDC co existing with DCIS and 300 IDC lesions were compared. The correlation between sonographie findings and histologic grades of pure DCIS were analyzed. Results Among three groups, significant differences were observed in mean lesion size, posterior phenomena, in-lesion microcalcifications and ductal changes; the sonographic features of IDC co-existing with DCIS group were regarded as the transition of the other two groups. Ultrasonography revealed an occupational lesion in 62 DCIS lesions （70.5 %） and architectural distortion in 26 lesions （29.5 %）. Microcalcifications were more common in high-grade DCIS lesions. A correlation between lesion size and histologic grade was also found. Conclusions With the progression of the pathological grade, the malignant sonographie features of DCIS also increase. Nearly one-third of the DCIS lesions were found without mass effect. Thus, more attention should be paid.

关 键 词：超声检查 导管原位癌 浸润性导管癌 乳腺 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]