16例炎性乳腺癌患者钼靶X线表现特征及病理结果分析

Molybdenum target X-ray features and pathological results of 16 patients with inflammatory breast cancer

目的:研究16例炎性乳腺癌(Inflammatory breast cancer,IBC)患者钼靶X线表现及病理结果,为该病患者的早期诊治提供参考依据。方法:回顾性分析从2019年1月至2021年10月于我院接受诊治的16例IBC患者病历资料。分析患者钼靶X线表现、病理结果以及免疫组化检查结果,并以病理结果为金标准,将所有IBC患者按照钼靶X线诊断结果的差异分为真阳性组12例以及假阴性组4例。比较两组患者临床病理特征及免疫组化检查结果。结果:16例IBC患者钼靶X线表现:(1)5例患者皮肤增厚,后缘模糊不清,且伴有乳头内陷;(2)皮下脂肪层密度明显增高,9例患者可见显著增粗的Cooper’s韧带;(3)腺体增厚,结构紊乱,3例在腺体内见明显形态不规则的肿块,其中1例伴有沙粒样钙化,10例未发现显著肿块,4例伴有弥漫分布的沙粒样钙化灶;(4)同侧腋窝均伴有淋巴结肿大,结构致密,边缘相对清晰。16例IBC患者均经病理诊断确诊为浸润性导管癌;其中6例皮肤内可见明显淋巴管癌栓;钼靶X线诊断炎性乳腺癌真阳性12例,假阴性4例。16例IBC患者经免疫组化检查结果显示:雌激素受体(Estrogen receptor,ER)阳性8例,占比50.00%,孕激素受体(Progesterone receptor,PR)阳性7例,占比43.75%,P53阳性10例,占比62.50%。钼靶X线假阴性IBC患者肿块大小≤5 cm、TNM分期为Ⅰ~Ⅱ期以及无淋巴结转移人数占比均高于真阳性患者(P均<0.05)。钼靶X线假阴性及真阳性IBC患者ER、PR及P53阳性人数占比差异无统计学意义(P均>0.05)。结论:IBC患者钼靶X线表现及病理结果均有一定的特征性,两者可为IBC的临床诊断提供参考。

Objective:To study the molybdenum target X-ray manifestations and pathological results of 16 patients with inflammatory breast cancer(IBC)to provide reference for early diagnosis and treatment of this disease.Methods:The medical records of 16 patients with IBC who were treated in the hospital from January 2019 to October 2021 were analyzed retrospectively.The molybdenum target X-ray manifestations,pathological results and immunohistochemical results of 16 patients with IBC were analyzed.Taking the pathological results as the gold standard,all patients with IBC were divided into the true positive group(12 cases)and the false negative group(4 cases)according to the difference of molybdenum target X-ray diagnosis results.The clinicopathological features and immunohistochemical findings of the two groups were compared.Results:The X-ray manifestations of molybdenum target in 16 patients with IBC were as follows:(1)5 patients had thickened skin,blurred posterior edge and inverted nipple.(2)The density of subcutaneous fat layer was significantly increased,and the significantly thickened Cooper's ligament was seen in 9 patients.(3)The glands were thickened and structurally disordered.Irregular masses were found in 3 cases,including 1 case with sandy calcification,10 cases without significant masses,and 4 cases with diffuse sandy calcification.(4)The ipsilateral armpits were accompanied by enlarged lymph nodes,with dense structure and relatively clear edges.All 16 patients with IBC were diagnosed as invasive ductal carcinoma by pathology.There were obvious lymphatic tumor thrombi in 6 cases.Molybdenum target X-ray diagnosis of inflammatory breast cancer is true positive in 12 cases,false negative in 4 cases.The results of immunohistochemical examination of 16 patients with IBC showed that 8 cases were positive for estrogen receptor(ER),accounting for 50.00%,7 cases were positive for progesterone receptor(PR),accounting for 43.75%,and 10 cases were positive for p53,accounting for 62.50%.The proportion of tumor size≤5cm,TNM stage I~Ⅱand no lymph node metastasis in patients with false negative molybdenum target X-ray IBC were 100.00%,which were higher than those of true positive patients(all P<0.05).The proportion of ER,PR and P53 positive in patients with IBC with false negative and true positive molybdenum target X-ray was not statistically significant(all P>0.05).Conclusion:The molybdenum target X-ray manifestations and pathological results of patients with IBC have certain characteristics,which can provide reference for the clinical diagnosis of IBC.