青年型乳腺癌的影像学表现、病理特征及免疫表达分析

Imaging features,pathological features and immune expression of breast cancer in young women

目的:探讨35岁以下青年型乳腺癌的影像特征和病理免疫表达,以提高对青年型乳腺癌的影像诊断水平。方法:筛选经病理证实、资料完整的女性乳腺癌患者215例,其中≤35岁52例(青年组),>35岁163例(对照组);分析2组数字乳腺摄影、超声表现和病理学的差异。结果:数字乳腺摄影表现为肿块毛刺征青年组为32.61%(15/46),对照组为92.11%(105/114),差异有统计学意义(P<0.05);可疑恶性钙化青年组为73.91%(34/46),对照组为55.26%(63/114),差异有统计学意义(P<0.05)。超声主要表现为中低回声肿块青年组为65.38%(34/52),对照组为38.04%(62/163),差异有统计学意义(P<0.05);实性肿块伴/不伴钙化青年组为21.15%(11/52),对照组为44.79%(73/163),差异有统计学意义(P<0.05);可疑恶性钙化青年组为19.23%(10/52),对照组为42.33%(69/163),差异有统计学意义(P<0.05)。青年组乳腺癌组织学Ⅲ级为46.15%(24/52),对照组为30.06%(49/163),差异有统计学意义(P<0.05);分子分型青年组Luminal A型为3.85%(2/52),对照组为23.31%(38/163),差异有统计学意义(P<0.05);HER-2过表达型青年组为25.00%(13/52),对照组为12.88%(21/163),差异有统计学意义(P<0.05);三阴型青年组为23.08%(12/52),对照组为6.13%(10/163),差异有统计学意义(P<0.05)。结论:35岁以下青年型乳腺癌的影像、病理表现具有特征性,综合分析,可提高早期检出阳性率和诊断符合率。

Objective:To investigate the imaging characteristics and pathological immune expression of breast cancer in young women under 35 years old and improve the imaging diagnosis level of breast cancer in young people.Methods:215 female breast cancer patients with pathological diagnosis and complete data were screened,52 cases of young breast cancer under 35 years old(including 35 years old)(youth group),and 163 cases of elderly breast cancer over 35 years old(control group).The differences in digital mammography,ultrasound and pathology between the two groups were analyzed.Results:The digital mammography showed that the mass spicule sign was 32.61%(15/46)in the young group and 92.11%(105/114)in the control group;the suspected malignant calcification rate of the young group was 73.91%(34/46),and that of control group was 55.26%(63/114),the differences were statistically significant(both P<0.05).Ultrasound showed that the middle-low echoic mass were 65.38%(34/52)in the young group and 38.04%(62/163)in the control group;the solid masses with or without calcification were 21.15%(11/52)in the young group and 44.79%(73/163)in the control group;the suspected malignant calcification rate were 19.23%(10/52)in the young group and 42.33%(69/163)in the control group,and the differences were statistically significant(all P<0.05).Histological gradeⅢbreast cancer were 46.15%(24/52)in the young group and 30.06%(49/163)in the control group,with statistical significance(P<0.05).The incidence of luminal A type was 3.85%in the young group and 23.31%in the control group,and the difference was statistically significant(P<0.05).The proportion of HER-2-overexpression type was 25.00%(10/163)in the young group and 12.88%(21/163)in the control group,and the difference was statistically significant(P<0.05).The proportion of the triple-negative type was 23.08%(12/52)in the youth group and 6.13%(10/163)in the control group,and the difference was statistically significant(P<0.05).Conclusions:The imaging and pathology of breast cancer in young people under 35 years old are characteristic.Comprehensive analysis of clinical and imaging findings can improve the positive rate and diagnosis coincidence rate of early breast cancer in young women.