摘要
目的探讨彩色多普勒超声在乳腺叶状肿瘤与纤维腺瘤鉴别诊断及不同病理类型乳腺叶状肿瘤诊断中的应用价值。方法回顾性分析在本院就诊并被病理证实的87个乳腺叶状肿瘤的超声声像图特征,并以病理证实的120个乳腺纤维腺瘤为对照(病理结果为诊断金标准)。结果乳腺叶状肿瘤患者的年龄大于乳腺纤维腺瘤患者,(39.86±9.68)岁比(34.23±12.33)岁(P<0.05);叶状肿瘤直径大于纤维腺瘤,(3.70±2.26)cm比(1.92±1.13)cm(P<0.05)。彩色多普勒超声显示,肿瘤形状、后方回声及内部是否存在无回声区在乳腺叶状肿瘤与纤维腺瘤之间的差异具有统计学意义(P<0.05);肿瘤大小和彩色多普勒血流分级是乳腺叶状肿瘤的独立危险因素(OR值分别为1.36和1.82,P<0.05)。患者年龄、肿瘤大小、纵横比及各种超声征象在良性、交界性、恶性乳腺叶状肿瘤中差异无统计学意义(P>0.05)。结论乳腺叶状肿瘤和纤维腺瘤在超声声像图特征上具有较多重叠,对年龄较大、肿瘤体积较大、内有无回声区、肿物后方回声衰减或肿物内血流丰富者应考虑乳腺叶状肿瘤的可能。不同病理类型的叶状肿瘤无特征性声像图表现。
Objective To investigate the value of color Doppler sonography in the diagnosis of phyllodes tumors with different pathologic types and in the differential diagnosis of phyllodes tumor and fibroadenoma. Methods The sonographic characteristics of 87 breast phyllodes tumors confirmed by histopathology from Janurary 2005 to December 2009 were retrospectively studied. In addition, 120 breast fibroadenoma confirmed by histopathology between June 2008 and August 2008 were set as the control group. The pathologic results were regarded as the gold standard. Results The patients with phyllodes tumors were older than the patients with fibroadenoma [ （39.86 ± 9.68） years vs. （34.23 ± 12.33） years; P 〈 0.05 ]. The diameter of phyllodes tumor was larger than that offibroadenoma [ （3.70±2.26） cm vs. （1.92 ±1.13） cm; P〈0.05]. As shown by color Doppler sonography, the shape of the tumor, retrotumor acoustic phenomenon, and cystic area were significantly different between phyllodes tumor and fibroadenoma （P 〈 0.05 ）. The tumor size and Color Doppler flow grade were independent risk factors of phyllodes tumors （ OR = 1.36 and 1.82, respectively ; both P 〈 0.05 ）. Benign, borderline, and malignant phyllodes tumors displayed no significantly different sonographic findings. Conclusions There is a substantial overlap in the sonographic characteristics between phyllodes tumors and fibroadenoma. If lobulation, posterior acoustic shadowing, and cystic area are observed under color Doppler sonography, a diagnosis of phyllodes tumor can be considered. Sonography can not distinguish benign, borderline, or malignant phyllodes tumors.
出处
《协和医学杂志》
2010年第1期66-71,共6页
Medical Journal of Peking Union Medical College Hospital
关键词
乳腺
叶状肿瘤
纤维腺瘤
超声
彩色多普勒
breast, phyllodes tumor
fibroadenoma
ultrasound
color Doppler
