乳腺癌微钙化对预后的影响及超声在钙化诊断中的应用

Influence of microcalcification on prognosis of breast cancerand application of ultrasound in diagnosis of calcification

目的分析多普勒彩色超声诊断乳腺癌微钙化的价值。方法回顾分析天津市河西医院2020年4月-2023年4月90例乳腺癌患者的资料,以病理结果为金标准,分析乳腺癌诊断微钙化的价值,分析微钙化是否与3年预后结果有关,分析彩色多普勒超声诊断微钙化准确性的影响因素。结果90例患者术后经病理确认73例钙化,17例无钙化;术后3年预后不良共16例,预后良好74例。微钙化主要超声特征:肿块内或周边有点状强回声,腺体内有点状强回声并沿导管走向分布;砂砾状或非砂砾状钙化,成簇状、弥漫状、孤立状分布,钙化肿块边缘粗糙多毛刺,形态不规则,不光整。预后多因素分析确认微钙化Ⅲ期和Ⅳ期是危险因素,术后放化疗是保护因素;超声诊断钙化特异度为56%,灵敏度为95.38%,准确率为84.44%;Logistic分析确认钙化直径≥2cm、钙化多形性、浸润癌是超声鉴别微钙化准确率的影响因素。结论微钙化是乳腺癌3年不良预后危险因素,多普勒超声能有效鉴别微钙化,其诊断效能受钙化大小、形态和肿瘤病理类型影响。

Objective The paper analyzed value of color Doppler ultrasound in diagnosis of microcalcification in breast cancer.Methods Taking pathological results as gold standard,data of 90 breast cancer patients from April 2020 to April 2023 were reviewed to analyze diagnostic value of microcalcification in breast cancer,whether microcalcification was related to the 3-year prognosis,and factors affecting accuracy of color Doppler ultrasound in diagnosis of microcalcification.Results Pathologically confirmed calcification in 73 cases and no calcification in 17 cases;a total of 16 cases had a poor prognosis in 3 years after surgery,and 74 cases had a good prognosis.Main ultrasound features of microcalcification:strong echo in or around the mass,strong echo in the gland,and distributed along the duct;Gritty or non-gravelly calcified,clustered,diffuse,isolated distribution,calcified mass edges are rough and burr,irregular shape,not smooth.Prognostic multivariate analysis confirmed that microcalcification,stage Ⅲ and stage Ⅳ were risk factors,and postoperative chemoradiotherapy were protective factors.The specificity of ultrasound diagnosis of calcification was 56%,the sensitivity was 95.38%,and the accuracy was 84.44%,and logistic analysis confirmed that the calcification diameter was≥2cm,calcification pleomorphism,and invasive carcinoma were the influencing factors of the accuracy of ultrasound identification of microcalcium.Conc lus ion Microcalcification is a risk factor for breast cancer 3 years after surgery,Doppler ultrasound can effectively differentiate microcalcification,and its diagnostic efficacy is affected by the size,shape and pathological type of calcification.