80例乳腺导管内癌的回顾性分析  

Retrospective analysis of the clinical data on 80 cases with breast ductal carcinoma in situ

作　　者：黎鹏飞[1] 张德杰[1] 杨先荣[1] 王启才[1] Li Peng-fei Zhang De-jie Yang Xian-rong Wang Qi-cai(Department of The Third General Surgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, Fujian, Chin)

机构地区：[1]福建医科大学附属龙岩市第一医院普三科,福建龙岩364000

出　　处：《兰州大学学报（医学版）》2017年第5期43-47,共5页Journal of Lanzhou University（Medical Sciences）

摘　　要：目的以80例乳腺导管内癌(DCIS)为对象,对临床特点、诊断方法、病理学特征进行回顾性分析研究,为诊断、治疗等提供临床经验。方法回顾性分析患者的年龄、临床症状(肿块、乳头溢液)、诊断方法 (彩色多普勒超声、钼靶摄片)、术后病理指标(原发肿瘤大小、组织学分级、腋窝淋巴结转移情况)及雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体-2(Her-2)和细胞增殖指数(Ki-67)。结果 DCIS发病年龄多集中在40—49岁之间,平均年龄(45.33±10.68)岁。彩色多普勒超声和钼靶摄片联合检查能大大提高乳腺癌的阳性检出率。在DCIS组中,不同组织学分级的ER、PR、Her-2、Ki-67差异均具有统计学意义;Ki-67在DCIS低级别组和中、高级别组比较中体现出差异,但差异无统计学意义;Ki-67在Her-2过表达型、三阴型之间无显著性差异。结论 DCIS多以体检发现肿物或乳头溢液起病,临床过程中多项检查联合评估可以提高DCIS检出率,在病理方面判断DCIS的预后需要综合ER、PR、Her-2、Ki-67以及组织学分级分析。Objective To retrospectively analyze the clinical,diagnostic and pathologic features of 80 patients with breast ductal carcinoma in situ（DCIS）,and to provide clinical experience on the diagnosis and treatment of the breast ductal carcinoma in situ.Methods Collecting the information including age,clinical symptoms,diagnostic methods and pathology of patients who were diagnosed as ductal carcinoma in situ from 2009 to 2015,and then analyze the detailed data such as the tumor size,histological grade,axillary lymph node involvement,estrogen receptor（ER）,progesterone receptor（PR）,human epidermal growth factor receptor 2（Her-2） and Ki-67 of pathology retrospectively.Results The onset age of DCIS was ranged from 40 to 49,and the average age was 45.33 ± 10.68.The union of color Doppler ultrasound and mammography could improve the diagnostic accuracy of DCIS,and the differences were significant.For the different histological grades of DCIS,obvious differences of the ER,PR,Her-2 and Ki-67 were found.The expression level of Ki-67 was different between the low grade and the middle as well as high grade of DCIS,but there was no obvious difference between the middle and high-grade groups.From the molecular typing of DCIS,it was found that the expression level of Ki-67 showed no difference between the Her-2 and tripe-negative groups.Conclusion The initial appearance of DCIS is nipple blood discharge or discovery of tumor from physical examination.The union of several examinations could improve the diagnostic accuracy of DCIS,and the prognosis of DCIS is related to ER,PR,Her-2,Ki-67 and histological grade.

关 键 词：乳腺导管内癌 雌激素受体 孕激素受体 人类表皮生长因子受体-2 KI-67 

分 类 号：R655.7[医药卫生—外科学]