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作 者:王小颖 关义满[2] 杨晓青[1] 乃赓 夏雪[1]
机构地区:[1]石家庄市第一医院超声科 [2]河北医科大学第三医院超声科,河北石家庄050051
出 处:《川北医学院学报》2017年第5期741-744,共4页Journal of North Sichuan Medical College
摘 要:目的:分析乳腺黏液癌超声诊断价值及其病理学基础。方法:收集52例乳腺黏液癌患者的临床资料,所有患者术前均接受常规超声及超声弹性成像(UE)检查,并与术后病理结果进行对照,总结乳腺黏液癌超声图像特点及病理特点。结果:(1)52例患者中单纯型乳腺黏液癌34例,混合型乳腺黏液癌18例。单纯型1例(3.23%),混合型6例(33.33%)发生淋巴结转移。单纯型乳腺黏液呈膨胀性生长,质地软,切面呈灰白色,见典型胶冻样,富光泽,镜下见黏液湖,黏液湖见断裂或吻合间质纤维分隔,核分裂少,细胞排列以小岛状排列为主,无脉管瘤栓;混合型黏液成分较单纯型增多,伴浸润性导管癌成分,细胞异性大,以巢状、腺管状为主;(2)52例乳腺黏液癌患者常规超声检出29例(55.77%),其中单纯型乳腺黏液癌16例(47.06%),混合型乳腺黏液癌13例(72.22%);单纯型乳腺黏液癌在常规超声见边界清晰,内部回声均匀,常呈椭圆形,瘤内无钙化,血流分级为0~1级,伴后方回声增强,均可见异常回声;混合型乳腺黏液癌见边界模糊,内部回声不均,形态不规则,瘤内见钙化,血流分级多为3级,伴后方回声衰减;(3)单纯型乳腺黏液癌SR、弹性评分均低于混合型乳腺黏液癌患者(P<0.05)。结论:乳腺黏液癌中单纯型在超声图上更易表现出良性影像学特点,混合型浸润程度则较单纯型高,更易呈现恶性特点,其组织硬度大,弹性评分高,且其超声特点与病理特征有其明显相关性。Objective:To analyze Ultrasonic diagnosis and pathological analysis of mucinous breast carcinoma.Methods:The clinical data of 52 patients with mucinous breast carcinoma were collected.All patients received routine ultrasonography and ultrasonic elastography (UE) before operation,and the results were compared with pathological results.The ultrasound findings and pathological features of mucinous breast carcinoma were summarized.Results:34 cases of simple mucinous breast carcinomas and 18 cases of mixed mucinous breast carcinoma were found in 52 cases.There was only 1 case (3.23%) of lymph node metastasis in simple type and 6 cases (33.33%) in mixed type.Simple type mucinous breast carcinomas showed expansive growth,soft texture and gray cut surface.They were typical gelatinous and shine,and there was mucin pool under microscope.There were fractures or anastomosis interstitial fibrous septa in mucin pool,with little nuclear fission.Cells showed small and island like arrangement,and there was no vascular invasion.The components of mixed type are more than those of simple type,with components of invasive ductal carcinomas.Cells were large,and were mainly nested,glandular and tubular.In 52 cases of mucinous breast carcinomas,29 cases (55.77%) were detected by routine ultrasonography,of which 16 cases were simple mucinous breast carcinomas (47.06%),and 13 cases were mixed type (72.22%).Routine ultrasonography of simple mucinous breast carcinomas showed clear boundaries,homogeneous internal echo,oval shape,no calcification in tumor,grade 0 - 1 blood flow,accompanied by posterior echo enhancement,and abnormal echo was observed.Routine ultrasonography of mixed breast mucinous carcinoma showed blurred boundaries,inhomogeneous internal echo,irregular shape,calcification in the tumor,and grade 3 blood flow,accompanied by attenuation of posterior echo.The SR and elasticity scores of pure mucinous breast carcinoma were lower than those of mixed type (P〈0.05).Conclusion:Simple mucinous brea
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