非肿块型乳腺癌的超声表现与其病理特征的相关性研究

摘要

目的:初步探讨非肿块型乳腺癌的超声表现与其病理特征的相关性.方法:选取病理证实的69例女性乳腺病变患者,共69个非肿块型乳腺癌.非肿块型乳腺癌的超声图像表现分为导管扩张型、片状低回声型、局部结构紊乱型及混合改变型.通过Pearson卡方检验或Fisher精确检验比较不同超声类型的病理特征.结果:导管扩张型中导管原位癌(DCIS)所占比例为81.8％,明显大于其他3种类型(P＜0.001);混合回声型中无DCIS,均为浸润癌;局部结构紊乱型中只有1例为DCIS(9.1％).导管扩张型(72.7％)及混合改变型(68.8％)中人表皮生长因子受体-2(HER-2)阳性率大于片状低回声型(40.0％)及局部结构紊乱型(27.3％),总体差异有统计学意义(P=-0.035).混合改变型(50.0％)较导管扩张型(0.0％)、片状低回声型(26.7％)及局部结构紊乱型(27.3％)腋窝淋巴结转移更常见,总体差异有统计学意义(P=0.019).结论:非肿块型乳腺癌的超声表现类型与其病理组织类型、HER-2表达情况及腋窝淋巴结转移有一定相关性.%Objective:To preliminarily explore the relationship between the ultrasonography findings of non-mass-like breast cancer and its pathologic features.Methods:Sixty-nine female patients with 69 pathologically confirmed non-mass-like breast cancers were enrolled in this study.The ultrasonography features of all the lesions were classified as four types:"duct dilatation","sheet low echo","local architecture distortion",and "mixed change." Pearson Chi-Square test and Fisher's exact test were performed to compare pathologic features of different ultrasonography types of non-mass-like breast cancer.Results:The proportion of ductal carcinoma in situ (DCIS) in the type of "Duct dilatation" was 81.8％,and significantly larger than the other three types(P＜0.001).No DCIS existed in the type of "mixed change" whose histologic type was all invasive cancer.The type of "local architecture distortion" had only one DCIS(9.1％).The positive rates of human epidermal growth factor receptor-2(HER-2) in the type of "duct dilatation"(72.7％) and "mixed change"(68.8％) were higher than in the type of "sheet low echo"(40.0％) and "local architecture distortion"(27.3％) and the difference was statistically significant on the whole (P=0.035).Axillary lymph node metastases were more commonly seen in the type of "mixed change"(50.0％) than in the type of "duct dilatation"(0.0％),"sheet low echo"(26.7％),and "local architecture distortion"(27.3％) and the overall different was statistically significant (P=0.019).Conclusion:Ultrasonography types of non-mass-like breast cancer have some correlation with histologic type,HER-2 expression and axillary lymph node metastasis.