分子分型在肿块型及非肿块型乳腺癌中的差异及其与X线征像关系研究

Difference of molecular subtype and its relationship with mammographic characteristics between mass-type and non-mass-type breast cancer

目的 探讨肿块型及非肿块型乳腺癌的临床及分子分型差异、X线征象与分子分型的关系。方法 纳入372例乳腺X线表现为肿块型或非肿块型并经病理证实为乳腺癌的女性患者的临床、病理及影像资料,其中肿块型共210例,非肿块型共162例,回顾分析两组临床及分子分型差异及不同分子分型乳腺癌X线征象差异。结果非肿块型病灶发生于相对低龄者,非浸润性癌占比高;肿块型患者相对高龄,以浸润性癌占比更高。Luminal B型多见于肿块型,Luminal HER-2型多见于非肿块型。不同分子分型的肿块型乳腺癌的影像特征如肿块是否伴随不对称及非肿块型乳腺癌的影像特征如结构扭曲、钙化等征象发生率、钙化形态等差异有统计学意义(P均<0.05)。结论 肿块型及非肿块型乳腺癌临床、病理特征及分子分型不同,部分X线征象与肿瘤分子分型有关,对治疗方案选择、预后判断等有一定价值。

Objective To investigate the molecular subtype differences between mass-type and non-mass-type breast cancer and explore the relationship between mammographic features and molecular subtype.Methods The clinical,pathologic and imaging data of 210 mass-type and 162 non-mass-type breast cancer cases were analyzed retrospectively to evaluate the potential associations between imaging features and molecular subtypes in these two groups.Results Non-mass type lesions are inclined to occurs in younger patients and with a higher rate of non-invasive carcinoma.The mass-type group has the opposite characteristics.Higher incidence rate of Luminal B can be observed in mass-type and Luminal HER-2 incidence rate was higher in non-mass-type.In mass type group,some mammographic features such as asymmetry accompaniment rate had statistical significance.In non-mass type group,incidence rates of architectural dis-tortion and calcification,morphology of calcification also had statistical significances.Conclusion There are some dif-ferences in clinical,pathologic characteristics and molecular subtypes between mass-type and non-mass-type group.Some mammographic features were proved to have discrepancies among several breast cancer molecular subtypes.It may be valuable in treatment selection and prognosis prediction.