摘要
目的探讨乳腺癌超声声像图表现与病理组织学分类、分级之间的联系。方法前瞻性研究121个乳腺癌病变。病变的超声征象包括:形态不规则、小分叶、毛刺、强回声晕、后方回声衰减、微小钙化、导管扩张。病理学研究包括组织学分类,浸润性导管癌组织学分级。结果121例乳腺癌中,4例无肿块形成,117例形成明确的肿块,其中106例(90.6%)为不规则或小分叶状肿块,11例(9.4%)为圆形或分叶状肿块。导管内癌、低分化浸润性导管癌(IDC)以及特殊类型的浸润性癌,圆形或分叶状肿块的例数分别为15.4%(2/13)、15.4%(4/26)、40.0%(4/10),高于高分化IDC组和中分化IDC组(P=0.004)。117例乳腺癌中,28例(23.9%)具有毛刺,45例(38.5%)具有强回声晕。在不同分化程度的IDC之间,以及IDC与浸润性小叶癌(ILC)之间,毛刺、强回声晕的出现频率差异均无显著性意义(P>0.05)。导管内癌和特殊类型浸润性乳腺癌无毛刺和强回声晕表现。25例(21.4%)乳腺癌具有后方回声衰减,导管内癌和特殊类型浸润癌中,未见后方回声衰减征象。61例(50.4%)乳腺癌具有微小钙化,微小钙化的发生率依次为导管内癌62.5%、中分化IDC57.8%、高分化IDC57.1%、低分化IDC46.2%、ILC37.5%,组间比较差异无显著性意义(P>0.05)。特殊类型的乳腺癌中钙化的发生率为10.0%,低于其他类型的乳腺癌(P=0.026)。51例(42.1%)乳腺癌有导管扩张,导管内癌和高、中、低分化IDC导管扩张的发生率分别为75.0%、40.5%、52.6%、34.6%,ILC无导管扩张出现。不同类型的导管扩张在不同分化浸润性导管癌中的发生频率无显著性意义(α校正=0.003)。结论乳腺癌超声声像图表现与病理组织学变化密切相关,肿块的超声形态特点对组织学类型和分级有提示作用。
Objective To determine the relationship of sonographic features to the histological typing and grading of breast cancer. Methods One hundred and twenty one breast cancers were prospectively evaluated with ultrasonography. Sonographic features included irregular shape, microlobulation, spiculated margin, halo, posterior attenuation, microcalcification, ductal distortion. Lesion morphology was analyzed and correlated with histopathologic results, which included tumor typing and grading. Results Irregular masses（ n=106） and rounded or lobular shape masses（ n = 11） accounted for the majority of 121 breast cancers. A rounded or lobular mass was strongly associated with ductal carcinoma in situ（DCIS）, poorly differential invasive ductal carcinoma（IDC）, or some of the specific invasive cancer（ P = 0. 004）. Twentyeight（23.9%） cases presented as spiculated margin, 45 （38.5%） as halo, 25 （21.4%） as acoustic shadowing, and they were most commonly IDC or invasive lobular carcinoma （ILC）. In a descending order, the following cancers were associated with calcifications： DCIS （62.5%）, grade Ⅱ IDC （57.8%）, grade ⅢIDC（57.1%）, grade ⅠIDC （46.2 % ）. Ductal distortion was associated with DCIS （75.0 % ） or invasive ductal carcinoma grade Ⅰ（ 40.5%）, invasive ductal carcinoma grade Ⅱ（52.6%）, invasive ductal carcinoma grade Ⅲ（34.6%）. Conclusions Gray-scale ultrasonography appearance of breast cancers is related to pathologic characteristics and can be a predictor of histopathologic pattern preoperatively.
出处
《中华超声影像学杂志》
CSCD
2005年第9期674-677,共4页
Chinese Journal of Ultrasonography
