乳腺浸润性导管癌超声与病理指标关系研究  

Study on the relationship between ultrasound and pathological indexes of breast invasive ductal carcinoma

作　　者：李兴旺 徐敏 沙梦玲 田甜 王岑竹 张薇[2] 丁莉[2] 唐金海[2] LI Xingwang;XU Min;SHA Mengling;TIAN Tian;WANG Cenzhu;ZHANG Wei;DING Li;TANG Jinhai(Graduate School of Xuzhou Medical University,Jiangsu Province,Xuzhou 221004,China)

机构地区：[1]徐州医科大学研究生学院,221004 [2]南京医科大学第一附属医院普外科,210029

出　　处：《疑难病杂志》2019年第11期1134-1138,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：国家自然科学基金(81872365);国家重点研发计划(2016YFC0905903)

摘　　要：目的研究乳腺浸润性导管癌超声指标与病理分子亚型、组织学分级和腋窝淋巴结转移的临床关系。方法回顾2018年1月—2019年1月南京医科大学第一附属医院普外科288例术后病理证实为浸润性导管癌患者的超声资料,分析其与病理分子亚型、组织学分级和淋巴结转移的相关性。结果直径≤2 cm及不平行于皮肤的肿块,以luminal B型最常见,luminal A型次之;直径>2 cm及平行于皮肤的肿块,仍以luminal B型最常见,HER2过表达型次之(P<0.05)。肿块直径≤2 cm、后方低回声(衰减)及不平行皮肤者多见于组织学Ⅰ、Ⅱ级,反之多见于Ⅲ级(P<0.05)。无论淋巴结转移个数多少,均以直径>2 cm及后方等回声(无改变)最常见(P<0.05)。不同超声BI-RADS分级的分子亚型或组织学分级差异均无统计学意义(P>0.05)。无淋巴结转移者BI-RADS 4C级较多见,而有转移者BI-RADS 5级较多见(P<0.05)。结论乳腺癌超声指标可一定程度上预测其分子亚型、组织分级及淋巴结转移,为临床治疗及判断其预后提供影像学方面的支持,具备潜在的临床推广应用价值。Objective To study the clinical relationship between the ultrasonic index of breast invasive ductal carcinoma and the pathological molecular subtype,histological grade and axillary lymph node metastasis.Methods From January 2018 to January 2019,the ultrasound data of 288 patients with invasive ductal carcinoma confirmed by pathology in general surgery of the First Affiliated Hospital of Nanjing Medical University were reviewed.The correlation between the ultrasound data and pathological molecular subtype,histological grade and lymph node metastasis was analyzed.Results Tumors≤2 cm in diameter and not parallel to the skin are most common with luminal B,followed by luminal A.The lumps of>2 cm in diameter and parallel to the skin were still most common with luminal B type,followed by HER2 overexpression(P<0.05).Tumor diameter≤2 cm,posterior hypoechoic(attenuation)and non-parallel skin were more common in histological gradesⅠandⅡ,and vice versa in gradeⅢ(P<0.05).Regardless of the number of lymph node metastases,echoes with no diameter>2 cm and posterior(no change)were the most common(P<0.05).There were no significant differences in molecular subtypes or histological grades between different ultrasound BI-RADS grades(P>0.05).BI-RADS 4C was more common in patients without lymph node metastasis,and BI-RADS 5 was more common in patients with metastasis(P<0.05).Conclusion Breast cancer ultrasound can predict its molecular subtype,tissue classification and lymph node metastasis to a certain extent,provide imaging support for clinical treatment and prognosis,and have potential clinical application value.

关 键 词：浸润性导管癌 超声指标 组织分级 淋巴结转移 BI-RADS分级 

分 类 号：R73[医药卫生—肿瘤]