乳腺具有髓样特征癌的超声和病理相关性研究  

Correlation Between Ultrasonography and Pathology Features Breast Carcinoma with Medullary Features

作　　者：李逢生[1] 宋灿许 袁权 岳瑾琢 杨晓民 程颢[1] 宋张骏 Li Fengsheng;Song Canxu;Yuan Quan;Yue Jinzhuo;Yang Xiaomin;Cheng Hao;Song Zhangjun(Department of Ultrasound,Xi’an Jiaotong University,Xi’an,Shaanxi 710061,China;Mammary Center,Shanxi Provincial Cancer Hospital Affiliated to Medical School,Xi’an Jiaotong University,Xi’an,Shaanxi 710061,China;Department of Ultrasound,Xi’an Daxing Hospital,Xian,Shanxi 710068,China;Department of Ultrasound.Shanxi Province People's Hospital,Xian,Shanxi 710016,China)

机构地区：[1]西安交通大学附属陕西省肿瘤医院超声科,西安市710061 [2]西安交通大学附属陕西省肿瘤医院乳腺中心,西安市710061 [3]西安大兴医院超声科,西安市710068 [4]陕西省人民医院乳腺中心,西安市710016

出　　处：《中国超声医学杂志》2021年第3期263-266,共4页Chinese Journal of Ultrasound in Medicine

基　　金：陕西省卫生健康委计划项目(No.2018D030)。

摘　　要：目的探讨乳腺具有髓样特征癌(MBC)超声和病理的相关性。方法查找我院诊治的乳腺癌患者资料,筛出有完整超声和病理资料的具髓样特征癌的患者41例进行相关性分析。结果41例具有髓样特征癌占同期收治IDC患者的4.4%(41/925)。包括髓样癌(组Ⅰ)26例(63.4%)、非典型髓样癌(组Ⅱ)9例(22%)及伴髓样特征的非特殊浸润性癌(组Ⅲ)6例(14.6%)。41例患者的肿瘤超声特征为:边界清晰87.8%(36/41),形态规则70.7%(29/41),内部回声均匀78%(32/41),后方回声增强75.6%(31/41),伴钙化4.9%(2/41),血流信号Ⅱ~Ⅲ级68.3%(28/41),BI-RADS 3类36.6%(15/41)、4A类41.5%(17/41)、4B类14.6%(6/41)和4C类7.3%(3/41)。镜下:肿瘤膨胀性边缘生长,界清,淋巴细胞浸润为主背景,间质成分少。免疫组化:ER、PR、HER-2的阳性率分别为7.3%(3/41)、7.3%(3/41)和9.8%(4/41),Ki67增殖指数为20%~97%。结论乳腺具有髓样特征癌的临床发病率低,分子分型多为三阴性癌,超声BI-RADS分类低,肿瘤形态规则、边界清与病理学膨胀性生长方式相符合。乳腺具有髓样特征癌的超声表现有其病理学依据。Objective To explore the correlation between ultrasonography and pathology of medullary breast cancer(MBC).Methods 41 patients with medullary characteristic cancer with complete ultrasound and pathological data were screened for correlation analysis.Results 41 cases of MBC accounted for 4.4%(41/925)of IDC patients in the same period.26 cases(63.4%)(groupⅠ)were myeloid carcinoma,9 cases(22%)(groupⅡ)were atypical myeloid carcinoma and 6 cases(14.6%)(groupⅢ)were nonspecific invasive carcinoma with myeloid characteristic carcinoma.The boundary was clear in 87.8%(36/41)patiets,the morphology was regular in 70.7%(29/41),the internal echo was uniform in 78%(32/41),posterior echo enhancement was shoned in 75.6%(31/41),accompanied by calcification was showed in 4.9%(2/41),and blood flow signal gradeⅡ-Ⅲwas showed in 68.3%(28/41),BI-RADS 3 category was 36.6%(15/41),BI-RADS 4 A category was 41.5%(17/41),BI-RADS 4 b was 14.6%(6/41)and 4 C was 7.3%(3/41).MBC was characterized by swelling marginal growth,clear boundary,lymphocyte infiltration as the main background,and few media components under the microscope.The positive rates of ER,PR and HER-2 were 7.3%(3/41),7.3%(3/41)and 9.8%(4/41)for immunohistochemistry,respectively.The proliferation index of Ki67 was 20%-97%.Conclusions The clinical incidence rate of breast carcinoma with medullary features is low.Most of the MBC molecular types are triple negative.The ultrasonic BI-RADS classification is generally low,and the tumor morphology is regular and the boundary is clear,which is consistent with the pathological expansion growth mode.The characteristic ultrasonic manifestations of MBC have its pathological basis.

关 键 词：乳腺髓样癌 超声诊断 病理 免疫组化 

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]