术前影像学检查对乳腺导管内癌手术方式的影响及其与术后病理组织分级的相关性

The effect of preoperative imaging examination on the surgical methods of patients with breast intraductal carcinoma and its correlation with postoperative pathological tissue grading

目的探讨术前影像学检查对乳腺导管内癌(DCIS)患者手术方式的影响及其与术后病理组织分级的相关性。方法回顾性分析行手术治疗的85例单侧DCIS女性患者的术前影像学检查资料和术后病理资料。结果85例DCIS患者中行乳房切除术的比例(92.9%)高于保乳术(7.1%)。术前超声检查提示的乳房肿块大小对手术方式的选择有影响(P<0.05),而钼靶检查提示的钙化类型对手术方式的选择无影响(P>0.05)。影像学检查提示的不同类型钙化与术后病理组织学分级具有相关性(P<0.05),肿块伴钙化型在中高级别组织学分级中所占比例高于其他病理类型。术前超声检查提示的乳房肿块大小与术后病理报告提示的瘤体大小具有较好的一致性(P<0.01,r=0.8604)。结论在疑似DCIS或穿刺明确为DCIS的患者作术前评估时获得超声及钼靶检查结果,可以根据钙化灶的情况预估病理组织学分级,进而指导手术方式的选择和预后的判断。

Objective To explore the effect of preoperative imaging examination on the surgical methods of patients with breast intraductal carcinoma(DCIS)and its correlation with postoperative pathological tissue grading.Methods The preoperative imaging data and postoperative pathological data of 85 female patients with unilateral DCIS who underwent surgical treatment in our hospital were retrospectively analyzed.Results The rate of mastectomy(92.9%)in 85 DCIS patients was higher than that of breast-conserving surgery(7.1%).The size of breast lumps indicated by preoperative ultrasound examination had an influence on the choice of surgery(P<0.05),while the type of calcification indicated by mammography had no influence on the choice of surgery(P>0.05).The different types of calcifications suggested by imaging examinations were correlated with postoperative histopathological grades(P<0.05),and the proportion of masses with calcification in the middle and high grade histological grades was higher than that of other pathological types.The size of the breast mass indicated by the preoperative ultrasound examination and the size of the tumor indicated by the postoperative pathology report had a good consistency(P<0.01,r=0.8604).Conclusion Ultrasound and mammography results can be obtained during preoperarive evaluation of patients with suspected DCIS or puncture clearly identified as DCIS.The histopathological grade can be estimated based on the condition of the calcification foci,and then guide the choice of surgical methods and make prognostic judgments.