乳腺钙化分布与形态和乳腺恶性肿瘤风险的相关性  

Correlation of the distribution and morphology of breast calcification with the risk of breast malignant tumors

作　　者：朱雨萱 杜钦 郭一泽 许楠馨 刘棣 ZHU Yuxuan;DU Qin;GUO Yize;XU Nanxin;LIU Di(Comprehensive Breast Care Center,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)

机构地区：[1]西安交通大学第二附属医院乳腺疾病诊疗中心,陕西西安710004

出　　处：《西安交通大学学报（医学版）》2024年第6期982-987,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：陕西省重点研发计划项目(No.2022SF-496);西安交通大学第二附属医院人才基金-科技骨干项目[No.RC(GG201807)];西安交通大学第二附属医院自由探索项目[No.YJ(ZYTS)2019012/No.2020YJ(ZYTS)226];新锐肿瘤支持治疗课题研究项目(No.cphcf-2022-231);医学科研发展基金项目(No.KM228009)。

摘　　要：目的分析乳腺X线下钙化分布与形态特征和乳腺恶性肿瘤风险的相关性,进一步揭示其在乳腺恶性肿瘤诊断的重要价值。方法收集2019年1月1日—2019年12月31日西安交通大学第二附属医院乳腺钙化并行穿刺活检及手术治疗患者108例,分析其影像学资料及术后病理结果。将乳腺X线下钙化分布按照节段/线样钙化、区域/弥漫性钙化分为两类,乳腺X线下钙化形态按照点状、细小分支状、多形、不定形及粗大钙化进行分类,探究乳腺X线下肿瘤钙化的分布、形态及BI-RADS分类,与乳腺恶性肿瘤发生、年龄、绝经状态、激素受体、分子分型的相关性。结果研究入组108例患者中,病理结果恶性为21例,良性为87例,结果显示钙化分布为节段/线样(χ^(2)=11.2,P=0.003)及钙化形态为细小分支型钙化(χ^(2)=9.3,P=0.046)在恶性肿瘤中的检出率显著高于良性肿瘤。钙化的分布与形态,与ER、PR、HER2、Ki67、病理类型、分子分型没有明显相关性(P>0.05)。logistics回归分析显示,钙化分布为节段/线样[OR=19.94(3.061~129.9),P=0.002]、钙化形态为细小分支状[OR=3.906(1.141~13.37),P=0.030]和BI-RADS分类为4类及以上[OR=39.99(2.703~591.7),P=0.007]与恶性肿瘤的发生密切相关。结论对于乳腺X线下可检出钙化的乳腺肿瘤患者,其影像学特征与恶性肿瘤的发生有密切联系。钙化分布为节段/线性、钙化形态为细小分支/不定形为恶性肿瘤的可能性较大,与乳腺恶性肿瘤的发生关系密切。Objective To analyze the correlation of the distribution and morphological characteristics of breast calcification with the risk of breast malignant tumors,so as to further reveal the important value of the calcification in diagnosis of breast malignant tumors.Methods A total of 108 patients who had received concurrent puncture biopsy and surgical treatment of breast calcification at The Second Affiliated Hospital of Xi’an Jiaotong University from January 1,2019 to December 31,2019 were recruited,and their imaging data and postoperative pathological results were analyzed.We divided the distribution of breast X calcification into two categories based on segmental/linear calcification and regional/diffuse calcification.We classified the morphology of breast X calcification into punctate,small branching,polymorphic,amorphous,and coarse ones.We then explored the distribution,morphology,and BI-RADS classification of tumor calcification under breast X-ray,and its correlation with the occurrence,age,menopausal status,hormone receptors,and molecular typing of breast malignant tumors.Results Among the 108 patients enrolled in the study,21 cases were malignant and 87 cases were benign.The results showed that the distribution of calcification was segmental/linear(χ^(2)=11.2,P=0.003)and the calcification morphology was of small branching calcification(χ^(2)=9.3,P=0.046).The detection rate in malignant tumors was significantly higher than that in benign tumors.The distribution and morphology of calcification were not significantly correlated with ER,PR,HER2,Ki67,pathological type,or molecular typing(P>0.05).Logistic regression analysis showed that menopausal status was already menopausal[OR=12.700(1.107-145.6),P=0.041],calcification distribution was segmental/linear[OR=19.94(3.061-129.9),P=0.002],calcification morphology was small branching[OR=3.906(1.141-13.37),P=0.030],and B-RADS classification was 4 grade and above[OR=39.99(2.703-591.7),P=0.007],which were closely related to the occurrence of malignant tumors.Conclusio

关 键 词：乳腺钙化 乳腺肿瘤 乳腺X线 临床诊断 

分 类 号：R737.9[医药卫生—肿瘤]