乳腺癌全数字化X射线摄影征象与病理的对照分析

Comparison of the FFDM manifestations and pathological feathures on breast cancer

目的:探讨乳腺癌全数字化乳腺X射线摄影(FFDM)征象与病理类型及分级的关系。方法:收集经病理确诊的乳腺癌患者242例,均常规行FFDM检查,对照分析FFDM征象与病理类型及分级的关系。结果:FFDM显示肿块174例,钙化117例,结构扭曲23例,局灶性致密影12例,导管征22例;浸润性导管癌多表现为单纯肿块或肿块伴钙化,导管内癌多表现为单纯钙化,单纯肿块、肿块伴钙化和单纯钙化在各病理类型乳腺癌之间的差异有统计学意义,P<0.05;除黏液癌和髓样癌肿块边缘多较清楚,其他类型癌多呈星芒状和浸润状边缘,肿块边缘和钙化分布的特征在各病理类型间的差异有统计学意义,P<0.05。乳腺癌病理分级与有无肿块、有无钙化、有无局灶致密影无关(P>0.05),与肿块外形是否规则、肿块边缘是否有星芒征、有无结构扭曲有关(P<0.01),Ⅲ级肿瘤的结构扭曲率、肿块不规则者及星芒征高于Ⅰ和Ⅱ级。结论:乳腺癌的肿块、钙化等X射线特征与病理类型和分级有关。

OBJECTIVE： To explore the correlation between FFDM manifestations and pathological feathures of breast cancer. METHODS： Two hundred and fourty two cases of breast cancer con firmed by surgery and pathology were collected in the study. All the cases had been examined by FFDM before surgery. FFDM and pathological finds were analyzed to determine the correlation between them. RESULTS： Of all the cases, mass was detected in 174 cases, calcification was noticed in 117 cases, architectural distortion in 23 cases, focal asymmetrical density in 12 cases, ductal sign in 22 cases. Most of features in infiltrating ductal carcinoma were simple mass or mass with calcification, while in DCIS were simple calcification （P〈0.05）. Most of mass margin in mutinous carcinoma and medullary carcinoma were circumscribed. According to margin of mass or distribution of calcification, there was significant difference between all pathological types of breast carcinoma （P〈0.05, respectively）. Histological grade was similar between carcinoma with and without mass, calcification or focal asymmetrical density （P〉0. 05）. Grade Ⅲ was more likely to be associated with spiculated mass, irregular mass and architectural distortion than grade Ⅰ and Ⅱ. There was significant relation among mass shape, mass margin, architecture distortion and histological grade of carcinoma （P〈0.01）. CONCLUSION： Pathological type and histological grade of breast carcinoma are related to mass, calcification and other FFDM features.