早期乳腺导管内癌钼靶X线表现及免疫组化分析

FEATURES OF MAMMOGRAPHY AND IMMUNOHISTOCHEMISTRY OF EARLY BREAST DUCTAL CARCINOMA

目的探讨乳腺导管内癌(DCIS)及导管内癌伴微浸润(DCIS-MI)的钼靶X线表现、免疫组化表达情况,分析二者之间的相关性。方法回顾性分析20例乳腺DCIS及36例乳腺DCIS-MI病人的钼靶X线表现,分析雌激素受体(ER)、孕激素受体(PR)、C-erbB-2及p53基因的表达情况,并分析影像学表现与上述标志物之间的相关性。结果钼靶X线表现为钙化33例,其中单纯钙化21例,钙化合并包块5例、结构紊乱5例、结节1例、腺体增厚1例;恶性钙化27例,中间钙化4例,良性钙化2例。表现为单纯包块2例、结节4例、结构紊乱9例、皮肤增厚2例。表现为阴性者6例。ER、PR、C-erbB-2、P53的阳性表达率分别为52.9%、52.9%、45.1%、58.8%。以非钙化组为对照组,恶性钙化与ER、PR、P53的表达无关(P>0.05),而与C-erbB-2表达有显著的相关性(χ2=4.850,P<0.05)。结论乳腺DCIS及DCIS-MI的钼靶X线主要表现为钙化,恶性钙化与C-erbB-2的表达相关。

Objective To evaluate the mammographic features of breast ductal carcinoma in situ（DCIS） and DCIS with micro-invasion（DCIS-MI） and the expression of its immunohistochemistry,and analyze the correlation between the immunohistochemistry and the mammographic features. Methods A retrospective analysis of X-ray imaging of 20 patients with DCIS and 36 with DCIS-MI was done.The expressions of estrogenic receptor（ER）,progesterone receptor（PR）,C-erbB-2,and p53 gene,and the correlation between the image manifestations and the above markers were analyzed. Results Mammography showed calcification in 33 cases,in which,21 showed a simple calcification;calcification combined with mass in five,combined with structural abnormality in five,with nodules in one and with thickened gland in one.Malignant calcification was seen in 27,intermediate-type calcification in four,and benign calcification in two.A simple mass was manifested in two cases,nodules in four,structural disorder in nine,and thickened skin in two.Six cases showed negative findings.The positive expression rates of estrogen receptor（ER）,progesterone receptor（PR）,C-erbB-2,and P53 were 52.9%,52.9%,45.1%,and 58.8%,respectively.Taking noncalci group as the control group,the malignant calcification was not correlated with the expressions of ER,PR and P53（P〈0.05）,but significantly related to C-erbB-2（χ2=4.850,P〈0.05）. Conclusion The main mammographic feature of DCIS and DCIS-MI is calcification.The detection rate of malignant calcification is associated with the expression of C-erbB-2.