乳腺Paget's病的影像学特征分析

Imaging Feature Analysis of Mammary Paget's Disease

目的:通过分析乳腺Paget's病的影像学特征,提高对本病的检出率和认识。方法:回顾性分析68例三家三甲医院自2000年1月至2022年6月期间病理学确诊为Paget's病的患者,采用描述性统计分析其临床特征、X线、超声、磁共振成像(MRI)和病理学特征。结果:59例乳腺Paget's病患者纳入研究,59例累及乳头乳晕,8例累及皮肤,55例有乳内病变,15例出现腋下淋巴结转移者。乳内病变包含导管原位癌19例,浸润性导管癌16例,浸润性导管癌合并原位癌20例。分子分型包括Luminal A型12例,Luminal B型9例,人表皮生长因子受体2(HER2)过表达型32例,三阴型2例。X线对钙化灶的探测较显优势;超声对肿块、乳头乳晕侵犯和淋巴结的评估较有优势;MRI对乳头乳晕侵犯、非肿块病变的评估较有优势。结论:临床特征、X线、超声、MRI结合对诊断乳腺Paget's病具有较高的临床价值。

Objective By analyzing the imaging features of Paget's disease of the breast,the detection rate and understanding of this disease can be improved.Methods A retrospective analysis was performed on 68 patients diagnosed with Paget's disease pathologically from three hospitals from January 2000 to June 2022,including 59 patients who met the inclusion and exclusion criteria.Descriptive statistics were used to analyze their clinical,X-ray,ultrasound,magnetic resonance imaging(MRI)and pathological features.Results Among 59 patients with Paget's disease,59 patients had mammary papilla-areola complex invasion,8 patients had skin invasion,55 patients had intramammary lesions,4 patients had no intramammary lesions,and 15 patients had axillary lymph node metastasis.There were 19 cases of ductal carcinoma in situ,16 cases of invasive ductal carcinoma,and 20 cases of invasive ductal carcinoma complicated with carcinoma in situ.Molecular classification included Luminal A type(12 cases),Luminal B type(9 cases),human epidermal growth factor receptor-2(HER2)overexpression type(32 cases),and three negative type(2 cases).X-ray is superior in detecting calcification foci.Ultrasound was superior in the evaluation of tumor,papillary areolar invasion and lymph nodes.MRI has advantages in the evaluation of papillary areola invasion and non-mass lesions.Conclusion The combination of clinical features,X-ray,ultrasound and MRI is of great significance in the diagnosis of Paget's pathology of breast.