140例浸润性导管癌病例的微钙化病理归类分析

Pathological Classification of 140 Infiltrating Ductal Carcinoma Cases with Breast Microcalcifications

目的:通过研究浸润性导管癌微钙化病例的微钙化病理学特征,对140例浸润性导管癌微钙化进行病理学归类和分析。方法:分析140例浸润性导管癌微钙化病例HE切片下的病理特征,对微钙化进行归类,并分析其与导管原位癌(DCIS)的关系。结果:通过判断钙化灶是否在管腔内,是否伴凝固性性坏死,可将浸润性导管癌微钙化病例分为3类:Ⅰa型、管腔内伴凝固性坏死型,Ⅰb型、管腔内无坏死型,Ⅱ型、管腔外钙化型,70%的浸润性导管癌癌微钙化属于Ⅰa型,20%属于Ⅰb型,10%属于Ⅱ型(P<0.01);140例浸润性导管癌微钙化病例中,51%(72例)全部为浸润癌,49%(68例)的病例含有DCIS成分,68例含有DCIS成分的钙化病例100%(68例)属于管腔内型。结论:浸润性导管癌微钙化主要是以管腔内形式存在,并以伴凝固性坏死为主,含有DCIS成分的浸润性导管癌微钙化主要以管腔内形式存在,可为研究乳腺癌微钙化发生机制提供依据,并可能将微钙化作为浸润性导管癌中DCIS的一个标志。

Objective： To classify the infiltrating ductal carcinoma cases with breast microcalcifications by pathological characters. Methods： We analyze 140 infiltrating ductal carcinoma cases with breast microcalcifications to classify the breast microcalcifications, and to study the relationship between the ductal carcinoma in situ （DCIS） and breast microcalcifications. Results： According to the microcalcifications in or out of lumen, and with or without coagulation necrosis, we classify the breast microcalcifications in infiltrating ductal carcinoma into three types： type Ⅰ a （in lumen and with coagulation necrosis）, type Ⅰ b （in lumen and without coagulation necrosis）, and type Ⅱ（out of lumen）. Of the 140 cases, 70% were type I a, 20% were type I b, and 10% were type Ⅱ （P〈0.01） ; 51%cases were invasive ductal carcinoma （without DCIS）, while 49% were DCIS; 100% DCIS cases were in lumen. Conclusion： The breast microcalcifications in infiltrating ductal carcinoma are mainly in lumen with coagulation necrosis. The microcalcifications with DCIS primary are in lumen, which may contribute to the forming of breast microcalcifications. The microcalcifications in infiltrating ductal carcinoma can be used as the markers for DCIS in clinic.