三阴性与非三阴性乳腺癌的X线特征探讨

Mammographic features of triple-negative and non-triple-negative breast cancer

目的与非三阴性乳腺癌(non-TNBC)比较,探讨三阴性乳腺癌(TNBC)的乳腺X线特征。方法根据ER、PR、HER2表达情况,将737个乳腺癌肿块分成TNBC组(n=112)和non-TNBC组(n=625),回顾性分析两组患者的X线图像及临床病理资料。结果 TNBC肿瘤组织学分级高,腋窝淋巴结转移率高于non-TNBC组(P<0.05)。在钼靶X线中,TNBC主要表现肿块(69.7%),很少表现为肿块伴钙化(16.5%)、局限性非对称致密(4.6%)、单纯钙化(2.8%)和结构扭曲(6.4%);肿块形状多为圆形(30.9%)或椭圆形(38.3%),很少表现为不规则形(11.7%);肿块边缘多为清晰边缘(30.9%),毛刺肿块少见(19.1%)。non-TNBC通常表现为肿块伴钙化(43.5%),钙化多见(58.8%);肿块形态主要为分叶形(40.4%)和不规则形(28.9%),毛刺征多见(43.6%)。结论 TNBC有其独特的影像表现,更倾向于良性肿瘤的特点,了解其X线特征有助于提高TNBC的诊断水平。

Objective To investigate the mammographic features of triple-negative breast cancer （TNBC） in comparison to non-triple-negative breast cancer （non-TNBC）. Methods According to the expression of ER, PR, and HER2, 737 breast cancers were divided into TNBC group （n= 112） and non-TNBC group （n= 625）. And then we retrospectively ana- lyzed mammographic and clinicopathologic findings of the two groups. Results TNBC was associated with higher tumor grades and more axillary lymph node involvement （ P 〈0.05）. On mammography, TNBCs frequently presented with mas- ses （69.7 %） and were less associated with masses with calcifications （16.5 %）, focal asymmetric density （4.6 % ） , calcifi- cations alone （2. 8%） and architectural distortion （6. 4%）. Masses were most frequently round （30. 9%） or oval （38.3%） in shape and were less frequently irregular in shape （11.7%）. Masses with circumscribed margins were the most frequent （30.9 %）, but spiculated margins were rare （19.1%）. In contrast, in the non-TNBC group, masses with calcifi- cations were the most frequent （43. 5%） and calcifications were commonly observed （58. 8%）. Masses were most fre- quently lobular （40. 4%） or irregular （28. 9%） in shape, and masses with spiculated margins were the most frequent （43.6%）. Conclusion TNBC could have distinct mammographic features and is likely to manifest with benign imaging features. The mammographic findings might be useful for the diagnosis of TNBC.