乳腺浸润性癌钙化与临床病理因素之间的关系

Mammographic microcalcifications and its relationship with clinicopathologic features in breast cancer

目的:探讨乳腺癌可疑钙化与临床病理因素之间的关系及临床意义。方法:回顾性分析武汉大学中南医院2013年1月—2016年12月经手术切除并病理证实的192例乳腺浸润性癌病例资料,探讨乳腺可疑钙化与病理因素[雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子相关基因(HER-2)和Ki-67]以及肿瘤大小、淋巴结转移、肿瘤分期、年龄和绝经状态、预后等临床因素之间的关系。结果:192例乳腺浸润性癌患者,其中X线显示可疑钙化105例(56.4%),乳腺癌HER-2过表达组可疑钙化高于HER-2阴性组(69.0%vs 31.0%,P<0.05);可疑钙化与ER(P=0.201)和PR(P=0.104)表达没有相关性;可疑钙化与Ki-67的表达呈正相关(P=0.025);淋巴结阳性乳腺X线可疑钙化高于淋巴结阴性组(70.7%vs 29.3%);可疑钙化与肿瘤分期及肿瘤大小呈正相关(P=0.019;P=0.045);乳腺浸润性癌患者可疑钙化与肿瘤大小、乳腺分型、绝经状态、家族史等没有相关性。结论:浸润性乳腺癌可疑钙化X线表现与乳腺浸润性癌预后相关危险因素存在关联,可为乳腺癌术前手术方式的选择及评估预后提供重要依据。

Objective:To investigate the relationship between mammographic microcalcifications and breast cancer clinicopathologic features.Methods:A retrospective chart review was performed in 192 women with breast cancer.Tumor pathology(size,grade and lymph node metastasis),hormonal status(ER and PR expression),HER-2 over-expression,Ki-67 expression,presence of microcalcifications and demographic information(age and menopausal status)were collected.Results:By radiological analysis,bout 56.4%of the patients presented with mammographic microcalcifications on routine mammographic screening.Patients were more likely to have microcalcifications if they were HER-2 positive(69.0%vs 31.0%,P<0.05);There was no significant association between microcalcifications and ER(P=0.201)or PR(P=0.104);There was a positive correlation between microcalcifications and Ki-67(P=0.025);Patients with positive lymph nodes were more likely to present with microcalcifications than patients with negative lymph nodes(70.7%vs 29.3%).There was a positive correlation of microcalcifications with tumor grade(P=0.019)and tumor size(P=0.045);But no significant association was found between menopausal status or breast density and microcalcifications.Conclusion:There were some correlations between microcalcifications and risk factors of prognosis.Microcalcifications can provide imaging bases for breast cancer prognosis assessment and clinical treatment.