钼靶微钙化对乳腺癌的诊断及预后价值

The clinical diagnostic value and prognosis of breast cancer with mammography micro-calcifications

目的 通过研究乳腺钼靶显示微钙化的乳腺癌的临床生物学行为,为乳腺癌的诊断及预后评价寻找新的指标.方法 对315例原发性乳腺癌患者术前应用钼靶摄影机常规摄取乳腺轴位、斜位片,判断有无微钙化,并与肿瘤类型、大小、临床分期、组织学分级、腋下淋巴结转移情况及ER、PR、C-erbB-2等临床病理学指标进行分析,比较各临床指标与钼靶钙化的关系.结果 浸润性导管癌合并导管内癌组中微钙化阳性率显著高于单纯浸润性导管癌组（P〈0.05）.微钙化与临床分期呈正相关[以I期为对照,II期OR=1.822（95% CI 1.013~3.276）,III期OR=3.646（95% CI 1.772~7.503）,P〈0.05],与淋巴结转移呈正相关[OR=1.761（95%CI 1.124~2.760）,P〈0.05].微钙化与ER阳性表达呈正相关[OR=1.710（95%CI 1.078~2.712）,P〈0.05],与PR阳性表达呈正相关[OR =1.597（95%CI 1.023~2.494）,P〈0.05].结论 钼靶微钙化阳性患者更倾向于临床分期晚、腋窝淋巴结转移以及ER、PR阳性表达,能否作为判断预后的独立因素还有待进一步研究.

Objective To investigate the biological behavior of breast cancer with mammography showed micro-calcifications,search for new indicators for preoperative evaluation of prognosis.Methods 315 cases of primary breast cancer patients were enrolled,took preoperative mammography film with regular intake of breast axis and oblique view,these patients were divided into calcification and no calcification group.Analyzed clinical and pathological indicators such as tumor type,size,clinical stage,histological grade,armpit lymph node metastasis and ER and PR,C-erbB-2 and compared the clinical indicators with mammography calcification.Results The rate of malignant calcification group in invasive ductal cancer with intra-ductal carcinoma group was significantly higher than invasive ductal carcinoma group（P 0.05）.Calcification and clinical stage was positively correlated（take stage Ⅰ as control,stage Ⅱ;OR = 1.822,95%CI 1.013-3.276;stage Ⅲ;OR =3.646,95%CI 1.772-7.503,P 0.05）,calcification was positively correlated with lymph node metastasis（OR = 1.761,95%CI 1.124 ~2.760,P 0.05）.Malignant calcification was positively correlated with ER positive expression（OR =1.710,95%CI 1.078-2.712,P 0.05）,and PR positive expression（OR =1.597,95%CI 1.023-2.494,P 0.05）.Conclusion Mammography micro-calcification patients were more likely to be in late clinical stage and axillary lymph node metastasis,and ER and PR positive expression,whether as independent prognostic factors remains to be further studied.