乳腺癌线样或线样分支状钙化与病理类型和分子表达的关系

Correlation between fine linear or fine linear branching calcification on mammography and pathological type and molecular expression in breast cancer

目的:探讨乳腺癌线样或线样分支状钙化与组织病理学及分子表达之间的关系及临床意义,评价微钙化预测乳腺癌组织病理类型及分子亚型的可行性。方法:回顾性分析150例钙化型乳腺癌(非肿块)患者的病例资料,由两位高年资医师根据钙化形态(线样钙化或非线样钙化)进行分组,分析钙化形态与乳腺癌病理类型(乳腺导管原位癌、浸润性导管癌)及分子表达[雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子相关基因(HER2)]的关系。结果:乳腺导管原位癌(DCIS)中线样或线样分支状钙化组中伴局部微浸润的比例明显高于非线样或线样分支钙化组(27/37vs 9/22,P<0.05);线样或线样分支状钙化组中雌激素受体(ER)的表达率低于非线样或线样分支状钙化(8/22vs 22/34,P<0.05),而HER2的过表达率高于非线样或线样分支状钙化组(17/39vs 12/17,P<0.05)。结论:线样或线样分支状钙化与乳腺癌病理类型和分子表达具有一定的相关关系,可以为乳腺癌治疗策略的制定和预后预测的提供参考。

Objective： To evaluate the correlation between fine linear calcification or fine linear branching calcifications on mammography and histo-pathological findings and molecular expression in breast cancer, and further, to evaluate the fea- sibility of predicting pathological type and molecular subtype. Methods：l50 cases with breast cancer （non-mass） accompa- nied with calcification who underwent mammography were included in this study. Of this 150 cases, there were 94 cases with invasive ductal cancer （IDC）, 56 cases with ductal carcinoma in situ （DCIS）. The images were divided into two groups [-fine linear or fine linear branching calcificaion （FLBC） group and non-FLBC group] based on the morphology of microcalcifica- tion by two senior radiologists to analyze the correlation of microcalcification morphology with pathological type （DCIS with or without focal micro-invasion and IDC with or without DCIS） and molecular expression （including PR,ER and HER2）. Results：DCIS associated with micro-invasion was found more in FLBC group than in non-fine linear or non-FLBC group （27/37 vs 9/22,P〈0.05）,and the patients in FLBC group had lower ER expression than the non-FLBC group （8/22 vs 22/34, P〈0.05）. Fine linear or fine linear branching calcifications were associated with overexpression of HER2 （17/39 vs 12/17,P〈0.05）. Conclusion： Fine linear or fine linear branching calcifications of breast cancer are significantly correlated with pathological type and molecular expression. This finding may be useful for planning therapeutic strategy and predicting prognosis of breast cancer.