超声BI-RADS 3～4B类乳腺恶性肿瘤的病理特点及其与淋巴结转移关系的分析

Relationship between pathological features and lymph node metastasis in ultrasound BI-RADS category 3-4B breast cancer

目的:研究超声乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)3～4B类且病理证实为恶性的乳腺二维声像图特点,分析其病理特点及淋巴结转移情况。方法:回顾性分析南京医科大学第一附属医院176例患者超声BI-RADS 3～4B类并经手术后病理学检查证实为恶性肿瘤的190个病灶,包括肿块大小、形态、边缘、方位、后方回声、钙化、血流、病理类型、分子分型及淋巴结是否转移。结果:BI-RADS 3～4B类乳腺恶性肿瘤的病理类型主要为导管原位癌、黏液腺癌、乳头状癌及浸润性导管癌(X^2=45.566,P<0.05),其中淋巴结转移差异有统计学意义(X^2=7.449,P<0.05),病理分子分型差异无统计学意义(X^2=3.710,P>0.05)。结论:BI-RADS 3～4B类乳腺恶性肿瘤大多数为早期乳腺癌,随着超声BI-RADS分级增高,淋巴结转移率增加,但总体恶性程度较低,综合评估预后较好。

Objective:To study the characteristics of breast cancer with ultrasound Breast Imaging Reporting and Data System (BI-RADS)category 3-4B,which was pathologically proved to be malignant,and to explore the pathological classification and lymph node metastasis.Methods:A retrospective analysis of 176 BI-RADS category 3-4B breast cancer patients with 190 lesions was performed.The features including size,shape,edge,orientation,posterior echo,calcification,blood flow,pathological type, molecular typing and lymph node metastasis were analyzed.Results:The main pathological types included ductal carcinoma in situ,mucous adenocarcinoma,papillary carcinoma,and infiltrating ductal carcinoma (χ^2=45.566,P<0.05).There was significant difference in lymph node metastasis (χ^2=7.449,P<0.05),but no difference in molecular typing (χ^2=3.710,P>0.05).Conclusion: The majority of breast malignant tumors with BI-RADS category 3-4B are in early stage.With the increasing ultrasound grades,the rate of lymph node metastasis is rising,but the overall prognosis is better.