乳腺浸润性导管癌衰减超声征象与病理组织学分级相关性研究

CORRELATION OF THE POSTERIOR ECHO ATTENUATION ON ULTRASONOGRAPH,FIBROUS/CELLULAR RATIO AND HISTOPATHOLOGY GRADE WITH INFILTRATING DUCTAL CARCINOMA OF THE BREAST

目的：探讨乳腺浸润性导管癌（Infiltrating Ductal Carcinoma,IDC）后方回声衰减超声征象与纤维组织/癌细胞（Fibrous/Cellular,F/C）比值、组织学分级之间的相关性,评价依据后方回声衰减超声征象预测组织学分级的临床价值。方法：回顾性分析经手术病理证实的乳腺IDC患者110例二维超声声像。记录病灶大小、超声形态、有无微小钙化、后方回声增强、后方回声衰减度及超声诊断结果。进行IDC后方回声衰减度与F/C比值、组织学分级相关性分析。结果：在IDC 110例患者中病变直径0.7-4.0 cm,平均（2.36±0.82）cm。病灶后方回声增强7例,后方回声衰减103例,其中衰减Ⅰ度48例、Ⅱ度36例、Ⅲ度19例。IDC组织学分级：Ⅰ级29例;Ⅱ级66例;Ⅲ级15例。F/C比值：（＋）61例;（＋＋）38例;（＋＋＋）11例。IDC病灶后方回声衰减度与F/C比值呈正相关（rs=0.149,P=0.134）,与组织学分级呈负相关（rs=-0.179,P=0.077）,差异均无统计学意义（P〉0.05）。结论：IDC后方回声衰减度与病灶病理组织成分相关;IDC病灶后方回声衰减度对组织学分级有一定程度的提示作用。

Objective：To probe the relationship between the posterior echo attenuation on ultrasonographic signs,fibrous/cellular（F/C） ratio and histological grade in cases of infiltrating ductal carcinoma（IDC）of breast,evaluated the clinical value in predicting the histological grade by means of ultrasonograph.Methods：A total of 110 patients with pathologically confirmed with infiltrating ductal carcinoma（IDC） of breast were retrospected between January 2008 and September 2009.The size of breast tumor,ultrasonographic appearance of the type,micro-calcification,acoustic enhancement,posterior echo attenuation and ultrasound diagnosis were recorded.The correlation between the posterior echo attenuation of infiltrating ductal carcinoma（IDC）,the F/C ratio and histological grades was analyzed.Results：The lesion diameter was 0.7~4.0 cm in 110 IDC,with a median diameter of（2.36±0.82）cm.The ultrasonography showed acoustic enhancement in 7 cases,posterior echo attenuation in 103 cases,103 cases of posterior echo attenuation showed：Ⅰ in 48 cases;Ⅱ in 36 cases;Ⅲ in 19 cases lesions.F/C ratio：（＋） in 61 cases;（＋＋） in 38 cases;（＋＋＋） in 11 cases.Histological grades of the IDC： Ⅰ grade in 29 cases;Ⅱ grade in 66 cases;Ⅲ grade in 15 cases.The posterior echo attenuation and the F/C ratio was positively correlated（rs=0.149,P=0.134） in IDC,and negative correlation with histological grades（rs =-0.179,P=0.077）.Both of them were not statistically significant.Conclusion：IDC posterior echo attenuation ultrasound characteristics are associated with the pathological tissue in lesions.The posterior echo attenuation can prompt the histological grades in IDC.