乳腺包裹性乳头状癌超声声像特征分析  

Ultrasonic features of breast encapsulated papillary carcinoma

作　　者：张英[1] 董智芬 高雅[2] 魏金荣[3] ZHANG Ying;DONG Zhifen;GAO Ya;WEI Jinrong(Department of Ultrasound,the Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215004,China;Department of Ultrasound,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou,Jiangsu 215001,China;Department of Thyroid and Breast,the Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215004,China)

机构地区：[1]苏州大学附属第二医院超声科,江苏苏州215004 [2]南京医科大学附属苏州医院超声科,江苏苏州215001 [3]苏州大学附属第二医院甲乳外科,江苏苏州215004

出　　处：《中华实用诊断与治疗杂志》2023年第10期983-986,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：苏州市“科教兴卫”青年科技项目(KJXW2021017)。

摘　　要：目的分析乳腺包裹性乳头状癌(EPC)患者临床病理及超声资料,探讨超声声像特征与病理类型的关系。方法2016年4月—2022年12月苏州大学附属第二医院、南京医科大学附属苏州医院诊治EPC患者33例,均行手术治疗,术前均行乳腺超声检查,观察病灶部位、直径、形态、边缘、内部回声、性质(实性/囊性)、钙化等超声声像特征。33例患者术后均行组织病理检查,根据病理类型分为单纯性EPC组18例,EPC伴导管原位癌组8例,EPC伴浸润组7例,比较3组病灶部位、病灶直径、分子分型、手术方式及病灶形态、内部回声、Adler血流分级等超声声像特征。结果33例患者病灶超声声像表现为形态规则21例(63.6%),边缘光整24例(72.7%),后方回声增强19例(57.6%),不伴钙化33例(100.0%),血流丰富21例(63.6%);囊实性肿块27例(81.8%),实性肿块6例(18.2%)。27例囊实性肿块均呈囊实性混合回声,其中以囊性为主8例,囊实相当7例,实性为主12例;后方回声增强18例;囊壁或实性回声区Adler血流分级Ⅱ~Ⅲ级17例。6例实性肿块均呈低回声,形态不规则,其中边缘不光整4例,Adler血流分级Ⅱ~Ⅲ级;后方回声增强1例。3组病灶部位、病灶直径、分子分型、手术方式及病灶形态、边缘、内部回声、后方回声、Adler血流分级比较差异均无统计学意义(P>0.05)。结论EPC超声声像表现呈多样化,典型表现为囊实性混合回声、形态规则、边缘光整、血流丰富,但超声声像特征无法鉴别病理类型。Objective To analyze the clinicopathologic and ultrasonographic data of patients with breast encapsulated papillary carcinoma(FPC),and to investigate the relationship between the ultrasonic features and pathological classification.Methods Thirty-three patients with EPC were performed surgical treatment in the Second Affiliated Hospital of Soochow University and the Affiliated Suzhou Hospital of Nanjing Medical University from April 2016 to December 2022.All of them underwent breast ultrasonography before surgery to observe the ultrasonic features such as lesion location,diameter,morphology,margin,internal echogenicity,solid or cystic compositions,and calcification.According to the histopathological examination results,33 patients were divided into pure EPC group(n=18),EPC+ductal carcinoma in situ group(n=8)and EPC+invasive carcinoma group(n=7),and the location,diameter,molecular staging,surgical approach and ultrasonic features of the lesions such as the morphology,internal echogenicity and blood flow grading were compared among three groups.Results The ultrasonography of 33 patients showed regular morphology in 21 patients(63.6%),well-defined margin in 24 patients(72.7%),posterior echo enhancement in 19patients(57.6%),no calcification in 33 patients(100.0%),rich blood flow in 21 patients(63.6%),cystic solid masses in27 patients(81.8%)and solid masses in 6 patients(18.2%).The ultrasonography of 27 patients with cystic-solid masses showed mixed cystic-solid echoes,among whom 8 were predominantly cystic,7 were cystic-solid equivalent,and 12 were predominantly solid;18 patients were showed posterior echogenic enhancement;17 patients were showed cystic wall or solid echogenic blood flow Adler grade Ⅱ-Ⅲ.The ultrasonography of 6 patients with solid mass showed hypoechoic and irregular in morphology,including 4 patients with irregular edges and Adler grade Ⅱ-Ⅲ blood flow signals;1 paitent showed posterior echogenic enhancement.The location,diameter,molecular staging,surgical approach,morphology,edge,internal ech

关 键 词：乳腺肿瘤 包裹性乳头状癌 超声 病理类型 

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]