乳腺导管原位癌微钙化X线特征与病理的对照研究

Correlation between microcalcification features and pathology in breast ductal carcinoma in situ

目的:探讨通过乳腺导管原位癌(DCIS)微钙化X线特征判断DCIS生物学行为及预后的可能性。方法:回顾性分析2010年9月-2018年8月在本院经钼靶定位穿刺微钙化病灶并通过手术、病理证实的DCIS患者101例,搜集101例患者的乳腺钼靶及病理资料,将钙化形态分为细小多形性组与非细小多形性组,将钙化分布分为群集分布组与非群集分布组,分析钙化表现与ER、HER2、ER/HER2亚型、Ki-67表达及病理分级的相关性。结果:在细小多形性组与非细小多形性组中DCIS的ER(χ2=0.571,P=0.450)、HER2(χ2=0.019,P=0.890)、ER/HER2亚型(Fisher精确检验,P=0.214)、Ki-67(χ2=2.129,P=0.145)表达及病理分级(χ2=2.021,P=0.155)构成均无显著差异。在群集分布组与非群集分布组中DCIS的ER(χ2=17.460,P<0.001)、HER2(χ2=13.305,P<0.001)、ER/HER2亚型(Fisher精确检验,P<0.001)、Ki-67表达(χ2=8.117,P=0.004)及病理分级(χ2=17.241,P<0.001)构成均存在显著差异。结论:DCIS钙化分布特征与ER、HER2、ER/HER2亚型、Ki-67表达及病理级别具有相关性,为预后评估能够提供参考,钙化为群集分布的DCIS预后较好。

Objective:To explore the possibility of predicting the biological behavior and prognosis of breast ductal carcinoma in situ(DCIS)by microcalcification features on X-ray.Methods:Retrospective analysis was conducted on 101 cases of DCIS patients who had received mammography-targeted localization of microcalcification lesions before surgery in our hospital from September 2010 to August 2018.All cases were confirmed by pathology.The mammographic and pathological information of 101 patients were collected.According to microcalcification morphology,all cases were divided into fine pleomorphic group and non-fine pleomorphic group.At the same time,according to microcalcification distribution,all cases were divided into clustered distribution group and non-clustered distribution group.The correlations between the microcalcification features and the expression of ER,HER2,ER/HER2 subtype,Ki-67 index and pathological grading were analyzed.Results:There were no significant differences in the expression of ER(χ2=0.571,P=0.450),HER2(χ2=0.019,P=0.890),ER/HER2 subtype(Fisher's exact test,P=0.214),Ki-67 index(χ2=2.129,P=0.145)and pathological grading(χ2=2.021,P=0.155)between fine pleomorphic group and non-fine pleomorphic group.But,there were significant differences in the expression of ER(χ2=17.460,P<0.001),HER2(χ2=13.305,P<0.001),ER/HER2 subtype(Fisher exact test,P<0.001),Ki-67 index expression(χ2=8.117,P=0.004)and pathological grading(χ2=17.241,P<0.001)between clustered distribution group and non-clustered distribution group.Conclusion:Microcalcification distribution of DCIS is correlated with expression of ER,HER2,ER/HER2 subtype,Ki-67 index and pathological grading,which is valuable for prediction of biological behavior and prognosis in breast ductal carcinoma in situ.For DCIS with clustered microcalcification,a better prognosis can be predicted.