骨转移乳腺癌X线表现与免疫组化分型的相关性分析  

Correlation analysis between mammography manifestations and immunohistochemistry types of breast cancer with bone metastatic

作　　者：周霞 崔春晓[1] 林青[1] 李志明[1] 边甜甜[1] 苏晓慧[1] 张琦[1] 李妍[1] 李丽丽[1] ZHOU Xia;CUI Chunxiao;LIN Qing;LI Zhiming;BIAN Tiantian;SU Xiaohui;ZHANG Qi;LI Yan;LI Lili(Department of Breast Imaging,Affiliated Hospital of Qingdao University,Qingdao 266100,China)

机构地区：[1]青岛大学附属医院乳腺影像科,山东青岛266100

出　　处：《中国中西医结合影像学杂志》2024年第2期168-174,共7页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：21国家重点研发合作乳腺癌及宫颈癌筛查方案优选研究(2016YFC1303001)。

摘　　要：目的:分析骨转移乳腺癌的数字乳腺X线摄影特征与免疫组化分型的相关性,以及骨转移灶的CT与MRI表现,并与无远处转移乳腺癌进行对比。方法:回顾性分析经手术病理证实的乳腺癌骨转移患者和无远处转移患者各90例(90个病灶);比较骨转移乳腺癌与无远处转移乳腺癌X线表现及免疫组化的差异。结果:①骨转移乳腺癌肿块以高密度为主,无远处转移乳腺癌肿块以等密度为主,差异有统计学意义(P<0.05)。②骨转移乳腺癌肿块边缘以模糊为主,无远处转移乳腺癌以毛刺状为主,差异有统计学意义(P<0.05)。③骨转移乳腺癌首诊区域淋巴结转移所占比例高于无远处转移乳腺癌,差异有统计学意义(P<0.05)。④相比骨转移乳腺癌,无远处转移乳腺癌无T4期患者,差异有统计学意义(P<0.05)。⑤骨转移乳腺癌Luminal A型及Luminal B型组织学分级以Ⅱ级为主,三阴性及HER-2过表达型以Ⅲ级为主,差异有统计学意义(P<0.05)。⑥骨转移乳腺癌Luminal A型、Luminal B型、HER-2过表达型以肿块伴钙化为主,三阴性以肿块为主,差异有统计学意义(P<0.05)。⑦无远处转移乳腺癌Luminal A型、三阴性及HER-2过表达型,发生同侧腋窝淋巴结转移居多,Luminal B型多未发生同侧淋巴结转移,差异有统计学意义(P<0.05)。⑧无远处转移乳腺癌Luminal A型与Luminal B型组织学分级以Ⅱ级为主,三阴性及HER-2过表达型以Ⅲ级为主,差异有统计学意义(P<0.05)。结论:骨转移乳腺癌不同免疫组化分型对应的临床病理学特征及影像学特征不同,有助于临床医师预测不同免疫组化分型的骨转移可能性,为治疗提供参考。Objective:To analyze the correlation between the digital mammography characteristics and immunohistochemistry types of breast cancer with bone metastases.To analyze the CT and MRI manifestations of breast cancer with bone metastases and the comparison with breast cancer without distant metastases.Methods:A retrospective analysis was performed for 90 breast cancer patients(90 lesions)with bone metastases and 90 breast cancer patients(90 lesions)without distant metastasis.The X-ray findings and immunohistochemistry of the two groups were compared.Results:The lesions with bone metastases were mainly high-density,while the leisons without distant metastasis were mainly isodense,the difference was statistically significant(P<0.05).The margins of lesions with bone metastases were mainly blurred,the margins of lesions without distant metastasis were mainly burr-like,the difference was statistically significant(P<0.05).The proportion of lymph node metastases at the first diagnosis of breast cancer with bone metastatic was significantly greater than that of breast cancer without distant metastasis(P<0.05).Compared with the breast cancer patients with bone metastases,none of the patients without distant metastasis reached T4 stage,the difference was statistically significant(P<0.05).Histological grades of Luminal A and Luminal B types of bone metastatic breast cancer were mainly gradeⅡ,triple-negative breast cancer(TNBC)and HER-2 overexpression types were mainly gradeⅢ,the difference was statistically significant(P<0.05).Luminal A,Luminal B and HER-2 overexpression types of breast cancer with bone metastases were mainly masses with calcifications,TNBC was dominated by masses,the difference was statistically significant(P<0.05).Ipsilateral axillary lymphnode metastasis occurred in Luminal A,TNBC and HER-2 overexpression types of breast cancer without distant metastasis,and most of the Luminal B types did not have ipsilateral lymphnode metastasis,the difference was statistically significant(P<0.05).Luminal A and Luminal

关 键 词：乳腺癌 骨 转移 乳房X线摄影术 病理学 免疫组化分型 

分 类 号：R730.44[医药卫生—肿瘤] R737.9[医药卫生—临床医学]