不同病理类型乳腺黏液腺癌超声显像特征分析  

Analysis of uitrasonographic features of different pathological types of mucinous breast carcinomas

作　　者：王寅[1] 薛改琴[1] 李春花 Wang Yin;Xue Gaiqin;Li Chunhua(Department of Ultrasound,Shanxi Provincial Cancer Hospital,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院超声科,太原030013

出　　处：《肿瘤研究与临床》2018年第6期370-373,共4页Cancer Research and Clinic

摘　　要：目的 探讨不同病理类型的乳腺黏液腺癌超声显像特征,提高乳腺黏液腺癌的超声诊断率.方法 回顾性分析山西省肿瘤医院2014年1月至2015年12月经手术病理证实的42例乳腺黏液腺癌患者的声像图特征,根据病理类型进行声像图分析.结果 42例乳腺黏液腺癌患者（共46个病灶）病理类型包括单纯型24例,混合型18例.术前超声诊断癌性病灶符合率为93.5 %（43/46）,其中24例单纯型患者的27个病灶声像图多表现为椭圆形或分叶状（20/27,74.1 %）、边界清晰（21/27, 77.8 %）、内部回声均匀（17/27,63.0 %）、后方回声增强（11/27,40.7 %）;18例混合型患者的19个病灶声像图多表现为形态不规则（14/19,73.7 %）、边界不清（16/19,84.2 %）、内部回声不均匀（13/19,68.4 %）、后方回声衰减（13/19,68.4 %）.两种类型病灶的声像图特征比较,差异均有统计学意义（均P＜0.05）. 42例患者中13例存在共计76枚腋下淋巴结转移,术前超声提示12例患者的32枚腋下肿大淋巴结结构异常,检出率为42.1 %（32/76）.在单纯型患者和混合型患者中雌激素受体（ER）、孕激素受体（PR）及人表皮生长因子受体2（HER-2）阳性率分别为87.5 %（21/24）、79.2 % （19/24）、8.3 %（2/24）和83.3 %（15/18）、88.9 %（16/18）、5.6 %（1/18）,3种分子标志物阳性率在两种类型之间差异均无统计学意义（均P＞0.05）.结论 不同病理类型的乳腺黏液腺癌因所含组织成分不同,超声表现有所差异,单纯型与良性肿瘤相似,混合型表现出浸润性癌的特征.Objective To investigate ultrasonographic features of different pathological types of mucinous breast carcinomas （MBC）, and to improve the diagnosis rate of MBC. Methods The ultrasonographic features of 42 MBC cases between January 2014 and December 2015 in Shanxi Provincial Cancer Hospital were retrospectively analyzed according to pathological types. Results There were 24 cases of simple type and 18 cases of mixed type in 42 MBC cases （46 lesions in total）. The coincidence rate of preoperative ultrasound diagnosis for cancerous lesions was 93.5 % （43/46）, including 24 cases of 27 simple type lesions with oval form or lobulated （20/27, 74.1 %）, clear boundary （21/27, 77.8 %）, uniform internal echo （17/27, 63.0 %）, posterior echo enhancement （11/27, 40.7 %）, and 18 cases of 19 mixed type lesions with irregular shape （14/19, 73.7 %）, unclear border （16/19, 84.2 %）, uneven internal echo （13/19, 68.4 %）, posterior echo attenuation （13/19, 68.4 %）. The differences between the two types of ultrasound images were statistically significant （both P〈0.05）. Of 42 cases, 76 axillary lymph nodes were transferred in 13 cases. Preoperative ultrasonography showed that 32 axillary lymph nodes enlargement were abnormal in 12 cases, and the detection rate was 42.1 % （32/76）. The positive rates of estrogen receptor （ER）, progesterone receptor （PR） and human epidermal growth factor receptor 2 （HER-2） were 87.5 % （21/24）, 79.2 % （19/24）, 8.3 % （2/24） in simple type and 83.3 % （15/18）, 88.9 % （16/18）, 5.6 % （1/18） in mixed type respectively. There was no significant difference in the positive rates of 3 kinds of molecular markers among two types （all P〉0.05）. Conclusions Due to the different tissue components in different types of MBC, ultrasonic features show several differences. Simple type is similar to benign masses, while mixed type shows the characteristics of invasive carcinomas.

关 键 词：乳腺肿瘤 腺癌 黏液 超声 病理 

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]