乳腺癌不同分子病理分型与其数字乳腺三维断层摄影表现特征的相关性分析

The correlation analysis of the different molecular pathological typing and the features of digital breast three-dimensional tomography of breast cancer

目的探讨乳腺癌各分子病理分型与其数字乳腺三维断层摄影(DET)表现特征之间的相关性。方法回顾性分析158例经乳腺癌患者的临床病理资料,采用卡方检验或Fisher确切概率法及多因素Logistic回归法分析乳腺癌各分子病理分型与其DET表现特征之间的相关性。结果共164个病灶,其中非浸润性癌35个,非特殊类型浸润性癌127个(Ⅰ级24个,Ⅱ级71个,Ⅲ级32个),特殊类型浸润性癌(粘液腺癌)2个;Luminal A型18个,Luminal B1型(Her-2阴性)73个,Luminal B2型(Her-2阳性)26个,Her-2过表达型20个,三阴性型27个。乳腺肿块边缘毛刺、伴钙化、仅钙化、钙化分布及钙化形态在不同分子病理分型之间比较有统计学差异。多因素Logistic回归分析显示,肿块边缘毛刺在三阴性型中出现的可能性最小,与Luminal A型、Luminal B1型比较均有统计学差异。仅钙化在Her-2过度表达型中出现的可能性较Luminal A型更低。钙化段或线状分布在Her-2过表达型中出现的可能性高于三阴性型、Luminal B1型。粗糙不均匀钙化在Luminal B2型、Her-2过度表达型中出现的可能性均高于Luminal B1型。结论DBT对临床预测乳腺癌的分子病理分型、治疗方案的选择及预后具有参考价值。

Objective To discuss the relativity between the molecular pathological types of breast cancer and the features of digital breast three-dimensional tomography.Methods The clinicopathological data of 158 patients with breast cancer was retrospectively analyzed.Chi-square test or Fisher exact probability method and multivariate logistic regression method were used to analyze the correlation between the molecular pathological types of breast cancer and their DBT performance characteristics.Results A total of 164 lesions,including 35 non-invasive cancers,127 non-specific types of invasive cancers(24 gradeⅠ,71 gradeⅡ,32 gradeⅢ),and 2 special types of invasive cancer(mucinous adenocarcinoma);Luminal A type 18,Luminal B1 type(Her-2 negative)73,Luminal B2 type(Her-2 positive)26,Her-2 overexpression type 20,and triple negative type 27.There were statistical differences between different molecular pathological types of breast turnon with burrs,calcification,only calcification,calcification distribution and calcification morphology.Multivariate logistic regression analysis showed that the marginal burr of the tumor was the least likely to appear in the triple-negative type,which was statistically different from Luminal A and Luminal B1.Only calcification in Her-2 overexpression type was less likely than Luminal A type.The possibility of calcification segment or linear distribution in the Her-2 overexpression type was higher than that of the triple-negative type and Luminal B1 type.Rough uneven calcification was more likely to appear in Luminal B2 and Her-2 overexpression than Luminal B1.Conclusion DBT has reference value for clinical prediction of molecular pathological classification,treatment options and prognosis of breast cancer.