乳腺神经内分泌癌和浸润性导管癌超声表现对比分析  

Comparative analysis on ultrasonic features of neuroendocrine breast carcinoma and invasive ductal carcinoma

作　　者：王艳清[1] 张晓东[1] 林锦蓉[1] 付丽 陈双龙[3] 

机构地区：[1]厦门大学附属第一医院超声影像科,福建厦门361003 [2]厦门大学附属第一医院病理科,福建厦门361003 [3]厦门大学附属第一医院乳腺外科,福建厦门361003

出　　处：《中国现代医药杂志》2017年第11期1-5,共5页Modern Medicine Journal of China

摘　　要：目的对比分析乳腺神经内分泌癌(NEBC)和浸润性导管癌(IDC)的超声表现特点。方法对经病理确诊的26例NEBC和50例IDC患者的超声检查结果进行回顾性分析,总结它们的超声声像图特征。结果 26例NEBC患者中,1例超声未检出结节性病灶,余25例均见单发结节,其中4例(16%)结节呈囊实性改变,21例(84%)结节呈低回声改变,而50例(100%)IDC结节均呈低回声,未见囊性改变,两者差异有统计学意义(P=0.018)。多数NEBC与IDC结节边界欠清或不清(72%vs 82%,P=0.319)、形态不规则(76%vs 94%,P=0.060)、内部回声不均匀(84%vs96%,P=0.176)、结节内部测及Ⅱ?Ⅲ级血流信号(72%vs 88%,P=0.161)。与IDC相比,NEBC结节周边少有毛刺或蟹足样改变(8%vs 70%,P<0.001),周边不常伴有高回声晕(32%vs 60%,P=0.022),内部细小钙化不常见(24%vs 48%,P=0.046),后方回声衰减少见(12%vs 40%,P=0.013),NEBC结节横径均大于前后径(纵横比≥1,0%vs 38%,P<0.001)。NEBC的腋窝淋巴结转移率低于IDC,但差异无统计学意义(19.23%vs 36.00%,P=0.131)。结论 NEBC与IDC超声表现既有相似之处,又有各自不同特征,术前超声应详细检查并结合临床资料进行综合分析,有助于提高NEBC术前超声定性诊断的准确率。Objective To compare the ultrasonic features of neuroendocrine breast carcinoma（NEBC） and invasive ductal carcinoma（IDC）. Methods The ultrasonic characteristics of 26 patients with NEBC and 50 patients with IDC confirmed by histopathology were retrospectively reviewed and analyzed. Results Among 26 NEBC cases,one was not found a nodule. Of the 25 NEBC nodules,4（16%） showed mixed cystic and solid echoes,and 21（84%） were solid hypoechoic. All of the 50（100%） IDC nodules were solid hypoechoic. There was significant difference in cystic change between the NEBCs and IDCs（P=0.018）. Most of the NEBCs and IDCs had an unclear boundary（72% vs 82%, P=0.319）,an irregular shape（76% vs 94%, P=0.060）,heterogeneous echotexture（84% vs 96%, P=0.176） and intranodular grade Ⅱ？Ⅲ blood flow signals（72% vs 88%, P=0.161）. Compared with the IDCs, spiculated or crab-like margins（8% vs 70%, P0.001）,peripheral hyperechoic halos（32% vs 60%, P=0.022）,microcalcifications（24% vs 48%, P=0.046）, posterior acoustic shadowing（12% vs 40%, P=0.013）, and aspect ratio≥1（0% vs 38%, P 0.001） were less frequent in the NEBCs. The incidence of axillary lymph node metastasis in the NEBCs was lower than in the IDCs,but the difference was not statistically significant（19.23% vs 36.00%, P=0.131）. ConclusionThere are not only similar ultrasonic characteristics but also different ultrasonic features between the NEBCs and IDCs. Careful ultrasonic examination and comprehensively analyzing clinical data would be helpful to improve diagnostic accuracy rate of NEBC before surgery.

关 键 词：乳腺 超声检查 神经内分泌癌 

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]