乳腺癌超声表现与病理组织学分类的关联

Correlation between ultrasonographic findings of breast cancer and its histopathologic classification

目的探讨乳腺癌病灶的超声表现与其病理类型、分级之间的关系。方法选取2013年2月至2015年4月济宁医学院附属医院手术治疗的97例乳腺癌患者作为研究对象,术前均行B超检查、术后均行病理学检查,分析超声声像表现与乳腺癌的组织学分类、分级之间的关系。结果浸润性小叶癌患者的不规则肿块形态率(73.17%)、毛刺征阳性率(68.29%)均显著高于浸润性导管癌患者的不规则肿块形态率(39.29%)和毛刺征阳性率(41.07%),且差异具有统计学意义(χ2值分别为10.931、7.034,均P<0.05);浸润性小叶癌患者的微小钙化灶阳性征(24.39%)显著低于浸润性导管癌(91.07%),差异也具有统计学意义(χ2=45.092,P<0.05);两种病理类型患者的后方回声衰减率、血流阳性征差异均无统计学意义(χ2值分别为3.573、1.516,均P>0.05)。低分化乳腺癌的不规则肿块形态率(65.22%)、血流阳性征(82.61%)均显著高于高分化(21.21%)和中分化(42.42%)乳腺癌,且差异均具有统计学意义(χ2值分别为11.001、9.040,均P<0.05)。不同分化程度患者的毛刺征、后方回声衰减率、微小钙化灶发生率的差异均无统计学意义(χ2值分别为0.063、1.883、0.014,均P>0.05)。结论乳腺癌患者的病理学类型、组织分级与其超声检查征像特征具有一定的关系,术前超声诊断结果对病理学诊断具有提示作用。

Objective To explore the correlation between ultrasonographic findings of breast cancer and its histopathological classification and grading. Methods A total of 97 cases of breast cancer were selected as research objects. All these patients underwent surgical treatment at the Affiliated Hospital of Jining Medical College from February 2013 to April 2015. They received B ultrasound examination before operation and pathological examination after operation. Correlation between the ultrasonographic findings of breast cancer and its histopathological classification as well as grading was analyzed. Results Patients with infiltrating lobular carcinoma had significantly higher rate of irregular shape of mass（ 73. 17% vs 39. 29%） and positive rate of speculation sign（ 68. 29% vs 41. 07%） than patients with infiltrating ductal carcinoma. The difference was of statistical significance（ χ2value was 10. 931 and 7. 034,respectively,both P〈0. 05）.The positive rate of micro-calcification was significantly lower in patients with infiltrating lobular carcinoma（ 24. 39%） than pthose with infiltrating ductal carcinoma（ 91. 07%）. The difference was statistical significant（ χ2= 45. 092,P〈0. 05）. No statistically significant difference was identified between patients of the two different pathological types in posterior echo attenuation rate and positive sign of blood flow（ χ2value was 3. 573 and 1. 516,respectively,both P〈0. 05）. Patients with poorly differentiated breast cancer had significantly higher rate of irregular shape of mass（ 65. 22%） and positive sign of blood flow（ 82. 61%） than patients with high（ 21. 21%） or middle（ 42. 42%） differentiation of breast cancer. The difference was of statistical significance（ χ2value was 11. 001 and 9. 040,respectively,both P〈0. 05）. No statistically significant difference was identified in speculation sign,posterior echo attenuation rate and incidence rate of micro-calcification among patients with different differentiated degree of breast cancer（ χ2value was 0. 063,1. 883 and 0. 014,respectively,all P〈0. 05）. Conclusion Certain correlation exists between breast cancer patients＇ pathological type and histological grading with their ultrasonographic findings. Results of preoperative ultrasound examination of breast cancer act as an implication for its pathological diagnosis.