乳腺X线在198例青年乳腺癌患者中的应用价值探讨

The application value of mammography in 198 young patients with breast cancer

目的探讨乳腺X线在青年乳腺癌中的应用经验。方法调取2011年1月到2016年12月北大深圳医院初诊初治青年乳腺癌患者的乳腺X线胶片,请专科医生读取并复核乳腺X线的结果,按照乳腺密度、TNM分期和免疫组化分型对结果进行亚组分析。结果共收集符合条件的研究对象198例。按照乳腺密度分组,180例为C类乳腺,18例为D类乳腺,不同密度乳腺在各位相检查阳性率的差异均有统计学意义;按照TNM分期分组,其中0、Ⅰ、Ⅱ、Ⅲ和Ⅳ期病例分别有2例、47例、103例、39例和7例,不同TNM分期病例阳性率之间差异均有统计学意义;按照免疫组化分型分组,其中luminal A,luminal B,三阴和HER-2过表达型分别有17例、106例、54例和21例,不同免疫分型病例阳性率之间差异无统计学意义。结论乳腺X线摄片检查对青年乳腺癌有较高的阳性率,临床分期晚的阳性率高,乳腺结构致密的阳性率低。对于致密型乳腺,可以加做乳腺X线数字断层摄片,提高阳性率。

Objective To explore the value of mammography in young breast cancer. Methods The results of mammography from newly diagnosed young breast cancer patients at Peking University Shenzhen Hospital from January 2011 to December 2016,were read and reviewed by a specialist. All patients were divided in subgroups according to mammary gland density, TNM stage, and immunophenotype. Results A total of 198 eligible subjects were collected. According to the density of the breast,180 cases were C-type breast and 18 were D-type. The difference of positive rate of different density breast was statistically significant. The 0,Ⅰ,Ⅱ,Ⅱ,Ⅲ and Ⅳ cases were divided into 2 cases,47 cases,103 cases,39 cases and 7 cases respectively. The positive rates of the cases in different TNM staging were statistically significant. According to the immunohistochemical results,there were 17 cases,106 cases,54 cases and 21 cases of luminal A,luminal B,triple-negative and HER-2 overexpression types, respectively. There were no statistical differences between the positive rate of different immunophenotypic cases. Academic significance. There was no significant difference in the positive rate between 21 immunophenotyp cases. Conclusion Mammography examination has a high positive rate for young breast cancer. The positive rate of late clinical stage is high,and the positive rate of dense mammary gland is low. For dense breasts,digital breast tomosynthsis（DBT）can be added to improve the positive rate.