乳腺癌超声表现与其病理基础的相关性研究

摘要

Objective To evaluate the correlation of features favoring malignant described in the ultrasonographic breast imaging reporting and data system ( BI-RADS )lexicon with the corresponding histopathological features of breast cancer. Methods From June 2010 to January 2011, a total of 139 tumors in 139 patients with pathologically confirmed breast cancer were included and retrospectively analyzed. Ultrasonographic findings were described using features from the ultrasonographic BI-RADS lexicon ( mass shape, margin, lesion bounder, echo pattern, and posterior acoustic features ) and analyzed with their corresponding histopathological features.Results For reflecting infiltration of carcinoma cells into the surrounding breast tissues, the irregular shape showed a sensitivity of 97. 3％ and a specificity of 14. 8％ , as compared with a sensitivity of 99. 1％ and a specificity of 18. 5％ without limited margin, while echogenic halo yielded a sensitivity of 76. 6％ and a specificity of 80. 0％ in predicting tumor cells infiltrated into the adjacent fatty and fibrous tissue with surrounding stromal hyperplasia. Approximately 92. 8％ of the tumors were hypo-echoic , which were mainly determined by the ratio of carcinoma cells to stroma( P = 0.0126 ). Around 52. 5％ of the tumors revealed no posterior acoustic features and 30. 9％ demonstrated posterior shadowing, which were associated with both the number of collagenized fibroblastic stroma( P = 0.000 )and the ratio of carcinoma cells to stroma( P = 0.000 ). Conclusion These results demonstrated that there were good correlations between ultrasonographic BI-RADS indicators and histopathological findings. The breast cancer could be assessed by ultrasonographic BI-RADS.%目的 探讨提示肿块为恶性的超声BI-RADS描述术语与相关乳腺癌病理组织学特征的关系.方法 2010年6月至2011年1月我院经病理证实的139例乳腺癌患者的139个肿块,根据超声BI-RADS 指标(肿块形态,边缘,边界,内部回声和后方回声),回顾性分析这些指标与相应组织病理学的关系.结果 通过肿块形态特征反映肿瘤组织直接浸润周围的灵敏度为97.3%,特异度为14.8%;通过肿块边缘特征反映肿瘤组织浸润周围的灵敏度为99.1%,特异度为18.5%;通过高回声晕反映肿瘤浸润程度,引起间质反应性增生的灵敏度为76.6%,特异度为80.0%;92.8%的肿块内部为低回声,细胞:间质比值会导致肿块内部回声改变(P =0.0126);52.5%的肿块后方回声无改变,30.9%的肿块后方出现声衰减,后方回声特征主要取决于细胞:间质比值(P =0.000)和胶原含量(P =0.000).结论 提示肿块为恶性的超声BI-RADS描述术语与相关乳腺癌病理组织学间存在相关性,超声BI-RADS提供了评估乳腺癌的良好手段.