超声非肿块型乳腺疾病83例临床分析  

Clinical analysis of non-mass-like lesions on breast ultrasound in 83 cases

作　　者：张文杰[1] 任海亮[2] 张彤彤[3] 吴剑[1] ZHANG Wen-jie;REN Hai-liang;ZHANG Tong-tong;WU Jian(Department of Breast and Thyroid Surgery,the Third Hospital of Chengdu,Chengdu,Sichuan 610031,China;Department of General Surgery,the Third Hospital of Chengdu,Chengdu,Sichuan 610031,China;Gastrointestinal Minimally Invasive Center,the Third Hospital of Chengdu,Chengdu,Sichuan 610031,China)

机构地区：[1]成都市第三人民医院乳腺甲状腺外科,四川成都610031 [2]成都市第三人民医院普通外科,四川成都610031 [3]成都市第三人民医院胃肠微创中心,四川成都610031

出　　处：《中华实用诊断与治疗杂志》2021年第8期775-778,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金(81502075)。

摘　　要：目的分析超声非肿块型乳腺疾病的超声及组织病理特征,探讨超声非肿块型乳腺疾病恶性病变的影响因素。方法83例超声非肿块型乳腺疾病患者,均行超声检查和超声下穿刺活检组织病理检查,分析超声声像图与临床病理特征的关系。根据组织病理结果分为良性病变组52例和恶性病变组31例,比较2组临床病理特征。采用多因素logistic回归分析超声非肿块型乳腺疾病恶性病变的影响因素。结果超声检查提示有恶性风险征象者(BI-RADS≥4级)62例,活检组织病理检查证实恶性病变30例,良性病变32例;超声检查提示低风险者(BI-RADS 3级)21例,活检组织病理检查证实恶性病变1例,良性病变20例。导管内癌超声表现为低回声区域伴散在钙化比率(80.0%)高于浸润性小叶癌(33.3%)(P<0.05)。恶性病变组病变位于外上、外下象限比率(58.1%、32.2%)高于良性病变组(34.6%、21.2%)(P<0.05),病变位于内上、内下象限比率(6.5%、3.2%)低于良性病变组(19.2%、25.0%)(P<0.05),肿块直径≥5 cm(80.6%)、无周期性疼痛(67.7%)、发病时间<12个月(71.0%)及超声声像为低回声区域伴散在钙化点(54.9%)比率均高于良性病变组(36.5%、40.4%、42.3%、5.8%)(P<0.05)。无周期性疼痛(OR=4.572,95%CI:1.076~19.420,P=0.039)、肿块直径≥5 cm(OR=6.986,95%CI:1.496~32.623,P=0.013)、发病时间<12个月(OR=0.136,95%CI:0.030~0.614,P=0.009)、超声声像为低回声区域伴散在钙化点(OR=0.037,95%CI:0.001~0.992,P=0.049)是超声非肿块型乳腺疾病恶性病变的危险因素。结论无周期性疼痛、肿块直径≥5 cm、发病时间<12个月、超声显示低回声区域伴散在钙化点的超声非肿块型乳腺疾病患者为高风险患者。Objective To analyze the ultrasound and histopathological characteristics of non-mass-like lesions on breast ultrasound,and to explore the influencing factors of malignant lesions in patients with non-mass-like lesions on breast ultrasound.Methods Eighty-three patients with non-mass-like lesions on breast ultrasound underwent ultrasound examination and ultrasound-guided biopsy.The relationship between ultrasound image and clinicopathological characteristics was analyzed.According to the histopathological results,83 patients were divided into benign lesion group(n=52)and malignant lesion group(n=31).The clinicopathological characteristics were compared between two groups.Multivariate logistic regression analysis was used to assess the influencing factors of malignant lesions in patients with non-mass-like lesions on breast ultrasound.Results Ultrasound showed signs of malignant risk in 62 cases(BI-RADS≥4),and histopathology confirmed malignant lesions in 30 cases and benign lesions in 32 cases.Ultrasound showed signs of low risk in 21 cases(BI-RADS:3),and histopathology confirmed malignant lesions in 1 case,and benign lesions in 20 cases.The percentage of hypoechoic area with scattered calcification on intraductal carcinoma ultrasound(80.0%)was higher than that of invasive lobular carcinoma(33.3%)(P<0.05).The percentages of lesions in the upper outer and lower outer quadrants were higher in malignant lesion group(58.1%,32.2%)than those in benign lesion group(34.6%,21.1%)(P<0.05).The percentages of lesion in the upper inner and lower inner quadrants were lower in malignant lesion group(6.5%,3.2%)than those in benign lesion group(19.2%,25.0%)(P<0.05).The percentages of patients with tumor diameter of≥5 cm(80.6%),no periodic pain(67.7%),onset time<12 months(71.0%),and hypoechoic area with scattered calcification on ultrasound(54.9%)in malignant lesion group were higher than those in benign lesion group(36.5%,40.4%,42.3%,5.8%)(P<0.05).No periodic pain(OR=4.572,95%CI:1.076-19.420,P=0.039),tumor diameter≥5 cm(OR=6

关 键 词：超声非肿块型乳腺疾病 乳腺癌 超声检查 组织病理检查 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]