超声对乳腺单纯黏液癌与纤维腺瘤鉴别诊断的价值  

Differentiation of Pure Mucinous Carcinoma and Fibroadenoma on Ultrasound of the Breast

作　　者：王红莉[1] 胡越[1] 谭翠[1] 顾然[1] 梅静思 余玥幸 陈丽莉[1] 龚畅[1] WANG Hongli;HU Yue;TAN Cui;GU Ran;MEI Jingsi;YU Yuexing;CHEN Lili;GONG Chang(Breast Tumor Center,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation,Guangdong-Hong Kong Joint Laboratory for RNA Medicine,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院乳腺肿瘤中心、广东省恶性肿瘤表观遗传与基因调控重点实验室,粤港RNA医学联合实验室,广东广州510120

出　　处：《中山大学学报（医学科学版）》2024年第4期631-636,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(82371739,81872139,82072907);北京市希思科临床肿瘤学研究基金会项目(Y-Roche2019/2-0078,Y-pierrefabre202102-0107);中山大学中央高校基本科研业务费专项资金(2022005);广州地区高新、重大和特色技术项目(2023-2025年)(2023P-ZD14)。

摘　　要：【目的】探讨乳腺单纯黏液癌(PMC)和纤维腺瘤(FA)的超声表现差异,为临床鉴别诊断提供参考。【方法】回顾性搜集2012年1月至2021年1月间在中山大学孙逸仙纪念医院就诊的连续乳腺PMC初诊患者50例及2018年6月至2019年1月间的连续乳腺FA初诊患者100例超声资料。依据2013年版乳腺影像报告与数据系统(BI-RADS)评估两组病变的超声图像特征,并比较两组患者年龄、病变的长径及超声图像特征的差异。【结果】PMC患者中位年龄为47岁,而FA为33岁,PMC患者年龄较FA偏大,两者差异具有统计学意义(P<0.001)。PMC患者病变中位长径2.4 cm大于FA的1.8 cm,差异有统计学意义(P=0.001)。PMC中,70%(35/50)表现为不规则形,82%(41/50)与皮肤平行,92%(46/50)边缘不清晰,72%(36/50)内部呈低回声,68%(34/50)后方回声增强;FA中,69%(69/100)表现为卵圆形或圆形,98%(98/100)与皮肤平行,54%(54/100)边缘清晰,98%(98/100)内部呈低回声,75%(75/100)后方回声未见变化,PMC与FA相应超声表现的差异有统计学意义(P<0.001,P=0.001,P<0.001,P<0.001,P<0.001),而病变内是否存在钙化、病变的血流表现在两者间差异无统计学意义。【结论】与FA相比,PMC患者年龄及病变长径偏大,并且在超声上,大部分乳腺PMC的形态及边缘仍表现为浸润性癌的生长特点,同时,PMC的后方回声增强,是其独特的表现。【Objective】To investigate the difference of ultrasound characteristics between pure mucinous carcinoma(PMC)and fibroadenoma(FA)of the breast.【Methods】Ultrasound data of 50 continuous patients with breast PMC from January 2012 to January 2021 and 100 continuous patients with breast FA from June 2018 to January 2019 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were retrospectively reviewed.The ultrasound characteristics of the two groups were evaluated according to the 2013 BI-RADS Ultrasound Atlas,and the differences in age,maximum diameter a nd ultrasound charac teristics between the two groups were compared.【Results】The median age of PMC patients was 47 years and that of FA patients was 33 years.The age of PMC patients was higher than that of the FA group,and the difference between the two groups of patients was statistically significant(P<0.001).The median maximum diameter of PMC patients was 2.4 cm,which was greater than that of the FA group(1.8 cm),and the difference was statistically significant(P=0.001).Of the PMC,70%(35/50)were irregular,82%(41/50)were parallel to the skin,92%(46/50)had no circumscribed margin,72%(36/50)were hypoechoic,and 68%(34/50)had enhanced posterior echo.Of the FA,69%(69/100)were oval or round,98%(98/100)were parallel to the skin,54%(54/100)had circumscribed margin,98%(98/100)were hypoechoic,and 75%(75/100)had no posterior features.The differences in the above ultrasound characteristics between the PMC and FA groups were statistically significant(P<0.001,P=0.001,P<0.001,P<0.001,P<0.001).There was no significant difference between calcifications and blood flow.【Conclusions】Compared with the FA group,pa‐tients with PMC are older and the diameter of the lesions are larger.On ultrasound,the morphology and margin of most breast PMC still show the growth characteristics of invasive cancer.Meanwhile,the posterior echo of PMC is enhanced,which is a unique manifestation.

关 键 词：乳腺 黏液癌 单纯黏液癌 纤维腺瘤 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]