乳腺浸润性导管癌伴和不伴导管内癌成分的X线征象特点及临床病理特征比较

Comparative analysis of mammography and clinicopathological features of invasive ductal carcinoma of the breast with and without ductal carcinoma in situ components

目的比较乳腺浸润性导管癌(IDC)伴和不伴导管内癌(DCIS)的X线征象特点及临床病理特征。方法回顾性分析2016年11月至2023年11月在高密市人民医院诊治的324例原发性IDC患者的临床病理资料,患者均为女性,年龄26~82岁[(54.20±11.20)岁]。依据术后病理结果,将患者分为单纯IDC组(184例)和IDC-DCIS组(140例),比较两组患者在年龄、浸润癌组织学分级、腋窝淋巴结转移、乳房侧别、病灶象限位置、病灶深度、病灶X线长径、病变有无肿块、钙化、边缘毛刺、乳房皮肤增厚和乳头回缩等方面的差异。结果单纯IDC组患者年龄为(55.26±11.07)岁,IDC-DCIS组患者年龄为(52.73±11.30)岁,单纯IDC组患者的年龄明显高于IDC-DCIS组(t=2.02,P=0.044)。单纯IDC组的病灶X线长径为(2.67±1.15)cm,IDC-DCIS组的病灶X线长径为(3.19±1.97)cm,IDC-DCIS组的病灶X线长径明显长于单纯IDC组(t=-2.77,P=0.006)。单纯IDC组和IDC-DCIS组患者的淋巴结转移率(P=0.732)、患病乳房侧别(P=0.592)、病灶象限位置(P=0.862)、病灶深度(P=0.246)、浸润癌的组织学分级(P=0.175)和患侧乳头回缩(P=0.278)之间的差异均无统计学意义;单纯IDC组和IDC-DCIS组患者病灶内钙化(P<0.001)、肿块(P<0.001)、边缘毛刺(P=0.012)和乳房皮肤增厚(P=0.003)的差异均有统计学意义,单纯IDC组病灶内钙化较IDC-DCIS组少见,而单纯IDC组肿块、边缘毛刺、乳房皮肤增厚均较IDC-DCIS组多见。结论单纯IDC组患者的年龄较IDC-DCIS组高,IDC-DCIS组的病灶X线长径较单纯IDC组长;单纯IDC组病灶内钙化较IDCDCIS组少见,而单纯IDC组肿块、边缘毛刺、乳房皮肤增厚均较IDC-DCIS组多见,可为术前诊断提供参考价值。

Objective To compare mammography and clinicopathological features of invasive ductal carcinoma(IDC)of the breast with and without ductal carcinoma in situ components(DCIS).Methods A retrospective analysis was conducted on the clinicopathological data of 324 patients with primary IDC who were treated in Gaomi People's Hospital from November 2016 to November 2023.All patients were female,aged 26 to 82 years,with an average age of(54.20±11.20)years.Based on postoperative pathological results,patients were divided into the simple IDC group(184 cases)and the IDC-DCIS group(140 cases).Patients between the two groups were compared in terms of age,histological grade of invasive carcinoma,axillary lymph node metastasis,breast side,lesion quadrant position,lesion depth,lesion length on X-ray,presence of masses,calcification,spiculated margins,breast skin thickening and nipple retraction.Results The age of patients in the simple IDC group was(55.26±11.07)years,while those in the IDC-DCIS group was(52.73±11.30)years.The age of patients in the simple IDC group was significantly higher than that in the IDC-DCIS group(t=2.02,P=0.044).The lesion length on X-ray of the simple IDC group was(2.67±1.15)cm,while the lesion length on X-ray of the IDC-DCIS group was(3.19±1.97)cm.The lesion length on Xray of the IDC-DCIS group was significantly longer than that of the simple IDC group(t=-2.77,P=0.006).There was no statistically significant difference in lymph node metastasis rate(P=0.732),affected breast side(P=0.592),lesion quadrant position(P=0.862),lesion depth(P=0.246),histological grading of invasive carcinoma(P=0.175),and affected nipple retraction(P=0.278)between the simple IDC and IDC-DCIS groups;There were statistically significant differences in calcification(P<0.001),mass(P<0.001),spiculated margins(P=0.012),and breast skin thickening(P=0.003)between the simple IDC and IDC-DCIS groups.Calcification within the lesion was less common in the simple IDC group than that in the IDC-DCIS group,while mass,spiculated margins,and breast skin thickening were more common in the simple IDC group than that in the IDC-DCIS group.ConclusionsThe age of patients in the simple IDC group is higher than that in the IDC-DCIS group,and the lesion length on Xray of the IDC-DCIS group is longer than that of the simple IDC group.Calcification within the lesion was less common in the simple IDC group than that in the IDC-DCIS group,while mass,spiculated margins,and breast skin thickening were more common in the simple IDC group than that in the IDCDCIS group,providing reference value for preoperative diagnosis.