超声在浸润性导管乳腺癌鉴别诊断中的应用价值及特异性征象研究

The special significance of ultrasonographic manifestations of invasive ductal breast cancer and its value in differentiating and judging

目的:总结浸润性导管乳腺癌(IDC)患者超声影像下的特异性征象,分析超声血流参数与IDC肿瘤病理特征的关系,以期提高超声在IDC鉴别诊断及病理评估中的应用价值。方法:将60例IDC患者设为D组,60例浸润性小叶乳腺癌(ILC)患者设为L组,均予以超声检查,根据超声成像结果对比两组患者的特异性征象及血流参数指标(RI、PI、PSV),并分析超声血流参数与肿瘤病理特征的关系。结果:在超声特异性征象上,D组患者肿瘤位置非中央区者比例高于L组(P<0.05),肿瘤形态不规则者比例高于L组(P<0.05),边缘毛刺者比例低于L组(P<0.05),微钙化灶者比例高于L组(P<0.05)。在RI、PI、PSV指标值上,D组与L组差异比较,均无统计学意义(P>0.05)。同时,在RI、PI、PSV指标值上,相较于Ⅰ~Ⅱ期者,Ⅲ~Ⅳ期者更高(P<0.05);相较于高分化者,中低分化者更高(P<0.05);相较于未发生淋巴转移者,发生转移者更高(P<0.05)。结论:在超声影像下,IDC特异性征象主要表现为肿瘤位置主要位于非中央区,肿瘤形态多不规则,边缘毛刺、微钙化灶出现较多。且通过对患者超声血流参数的分析可为IDC病理特征的判断提供参考信息。

Objective:To summarize the special features of invasive ductal breast cancer(IDC)under ultrasound imaging,and to analyze the relationship between the tumor hemodynamic indicators and its pathological features,in order to improve the advantages and benefits of ultrasound in the diagnosis of IDC and the analysis of pathological features.Methods:60 cases of IDC patients were set as group D and 60 cases of invasive lobular breast cancer(ILC)patients as group L.The imaging results of both groups were obtained.The ultrasonographic signs with special characteristics and tumor hemodynamic indexes(RI,PI,PSV)were compared between the two groups,and the relationship between them and tumor pathological characteristics was analyzed.Results:In terms of ultrasound signs with special characteristics,the proportion of patients with non-central tumor location in group D was higher than that in group L(P<0.05),the proportion of patients with irregular tumor shape was higher than that in group L(P<0.05),the proportion of patients with marginal burr was lower than that in group L(P<0.05),and the proportion of patients with microcalcification was higher than that in group L(P<0.05).There was no statistical significance between group D and group L in the index values of RI,PI and PSV(P>0.05).At the same time,in terms of the index values of RI,PI and PSV,the clinical stageⅲ-ⅳgroup was higher than the stageⅰ-ⅱgroup(P<0.05),the low-differentiation group was higher than the highly differentiated group(P<0.05),and the lymph node metastasis group was higher than the non-metastatic group(P<0.05).Conclusion:Under ultrasound imaging,the IDC specific signs mainly showed that the tumor was mainly located in the non-central region,the tumor morphology was more irregular,and there were more burrs and microcalcification foci at the edge.Moreover,the analysis of patients’ultrasound blood flow parameters can provide reference information for the judgment of IDC pathological characteristics.