乳腺癌患者超声造影检查肿瘤微血管灌注特征与病理学关系探究

Microvascular perfusion characteristics of breast cancer by contrast-enhanced ultrasound and its comparison with pathology

目的:探讨乳腺癌患者超声造影检查肿瘤微血管灌注特征,并分析其与病理学的关系。方法:回顾性分析2019年2月至2021年3月唐山市人民医院收治的180例乳腺癌患者的临床资料,术前均行超声造影检查,术后标本送病理活检,观察超声造影下肿瘤微血管灌注特征,并分析其与病理学分型、分级的相关性。结果:180例患者超声造影主要表现为早期造影剂快速灌注[47.78%(86/180)]、造影剂缓慢填充[60.00%(108/180)]、造影剂达到峰值时肿块表现为高增强[52.78%(95/180)]、晚期造影剂退出快[42.78%(77/180)]、造影剂缓慢退出及廓清时有造影剂滞留[65.56%(118/180)]。180例患者中病理活检非浸润性癌16例(8.89%),浸润性小叶癌41例(22.78%),早期浸润性导管癌88例(48.89%),黏液腺癌10例(5.56%),髓样癌11例(6.11%),鳞癌8例(4.44%),硬癌6例(3.33%);超声造影下肿瘤微血管灌注特征与病理学分型无相关性(P>0.05)。180例患者中病理学分级Ⅰ级95例(52.78%),Ⅱ级49例(27.22%),Ⅲ级36例(20.00%);超声造影下肿瘤微血管灌注特征与病理学分级存在一定相关性(P<0.05)。结论:乳腺癌患者超声造影检查肿瘤微血管灌注特征和病理学分级有一定关系,分析患者的微血管灌注特征能为病理学分级提供重要依据。

Objective To study the characteristics of tumor microvascular perfusion by contrast-enhanced ultrasound(CEUS)in patients with breast cancer,and to analyze its relationship with pathology.Methods The clinical data of 180 breast cancer patients admitted to Tangshan People′s Hospital from February 2019 to March 2021 were retrospectively analyzed.They were examined by contrast-enhanced ultrasound before surgery,and the specimens were sent for pathological biopsy after surgery.The characteristics of tumor microvascular perfusion under CEUS were observed,and the correlation between the characteristics and pathological classification and grade were analyzed.Results The results of the CEUS showed that the contrast agentrapid infusion was 47.78%(86/180),slowly filled was 60.00%(108/180),the mass showed hyperenhancement when the contrast agent reached its peak was 42.78%(77/180),the contrast agent slowly withdrew was 42.78%(77/180),and the contrast agent retention in clearance was 65.56%(118/180).Pathological biopsy revealed that among 180 patients,16 patients(8.89%)were non-invasive carcinoma,41 patients(22.78%)were invasive lobular carcinoma,88 patients(48.89%)were invasive ductal carcinoma,10 patients(5.56%)were mucinous adenocarcinoma,11 patients(6.11%)were medullary carcinoma,8 patients(4.44%)were squamous carcinoma,6 patients(3.33%)were hard carcinoma(3.33%).There was no correlation between tumor microvascular perfusion characteristics and pathological classification under CEUS(P>0.05).Pathological biopsy showed that 95 patients(52.78%)were gradeⅠ,49 patients(27.22%)were gradeⅡand 36 patients(20.00%)were gradⅢ.There was a certain correlation between tumor microvascular perfusion characteristics and pathological grade under CEUS(P<0.05).Conclusions There is a certain relationship between tumor microvascular perfusion characteristics detected by CEUS and pathological grading in patients with breast cancer.Analysis of the microvascular perfusion characteristics can provide an important basis for pathological grading.