乳腺浸润性导管癌X线钙化征象与分子亚型相关性分析

摘要

目的 探讨乳腺浸润性导管癌X线钙化征象与分子亚型之间的相关性.方法 回顾性分析96例经病理证实为乳腺浸润性导管癌患者,患者资料包括术前X 线检查资料和术后病理组织学检查与免疫组化,应用2 检验或fisher精确概率法分析X 线钙化形态和分布与分子亚型之间的相关性.结果 粗糙不均质钙化形态在各分子亚型中以Luminal A 分子亚型居多,差异具有统计学意义(P < 0.05) .簇状钙化分布多见于Luminal B(Her-2 阳性) 分子亚型,差异具有统计学意义(P < 0.05) .钙化伴肿块和钙化伴腋窝淋巴结肿大多见于Luminal B(Her-2 阳性) 分子亚型,差异具有统计学意义(P < 0.05) ,钙化伴结构扭曲、钙化伴乳头回缩和钙化伴皮肤橘皮样改变各分子亚型间差异无统计学意义(P > 0.05) .结论 乳腺浸润性导管癌X 线钙化形态和分布在不同分子亚型中存在差异,通过X 线钙化形态和分布可术前反映其分子亚型,有助于指导临床治疗和判断预后.%Objective To investigate the correlation between calcification signs of mammography and molecular subtypes in breast infiltrating ductal carcinoma. Methods 96 cases of pathologically proven invasive ductal breast cancer patients were analyzed retrospectively. Patients had complete preoperative mammographic data and the postoperative histopathological and immunohistochemical results. Correlations between the calcification morphology and distribution of mammography and the molecular subtypes were analyzed by chi-square test and Fisher's exact test. Results The morphology of coarse heterogenous calcifcations was more common in the subtypes of Luminal A,and the difference was statistically significant (P < 0. 05). The distribution of clustered calcifications was more commonly associated with Luminal B(Her-2 positive) subtypes,and the difference was statistically significant (P < 0. 05). Calcification with mass and calcification with lymphadenectasis were mostly found in Luminal B (Her-2 positive) molecular subtypes,and the difference was statistically significant (P < 0. 05). Calcification with structural distortion, calcification with papillary retraction and calcification with skin orange peel were no statistically significant difference in the each subtype (P > 0. 05). Conclusion The mammographic morphology and distribution of calcifications in breast infiltrating ductal carcinomas differ in different molecular subtypes. The morphology and distribution of mammographic calcification can reflect its molecular subtype before surgery,which provides important significance in guiding clinical treatment and prognosis.