乳腺包裹性乳头状癌超声表现:与乳腺非特殊型浸润性癌相对照

Ultrasonic manifestations of breast encapsulated papillary carcinoma:Comparison with breast invasive breast carcinoma of non-special type

目的观察乳腺包裹性乳头状癌(EPC)超声表现,并与乳腺非特殊型浸润性癌(IBC-NST)进行对比。方法回顾性收集经病理确诊的14例EPC(EPC组),并按1∶2比例纳入28例年龄、性别及发病时间相匹配的IBC-NST(IBC-NST组)。比较组间声像图特征,应用多因素logistic回归分析筛选EPC超声独立预测因素,比较组间穿刺活检病理与术后病理符合率和术后病理所示腋窝淋巴结转移率。结果组间病灶横径、纵径、内部回声、后方回声及腋窝淋巴结肿大与否差异均有统计学意义(P均<0.05)。混合回声是EPC的独立危险因素、后方回声衰减是EPC独立保护因素(P均<0.05)。EPC组穿刺活检病理与术后病理符合率及术后病理所示腋窝淋巴结转移率均低于IBC-NST组(P均<0.05)。结论相比IBC-NST,EPC超声多表现为相对较大病灶内部呈混合回声(囊实性)、后方回声增强或无变化,少见腋窝淋巴结转移。

Objective To observe ultrasonic manifestations of breast encapsulated papillary carcinoma(EPC)in comparison with breast invasive breast carcinoma of no special type(IBC-NST).Methods A total of 14 cases with pathologically confirmed EPC(EPC group)were retrospectively collected,and 28 cases of IBC-NST(IBC-NST group)with matched age,sex and time period were enrolled at the ratio of 1∶2.The ultrasonic findings were compared between groups,and the ultrasound-related independent predictors for EPC were screened using multivariate logistic regression analysis.The coincidence rate of biopsy pathology to postoperative pathology,as well as the axillary lymph node metastasis rate indicated by postoperative pathology were compared between groups.Results There were significant differences of lesions’transverse diameter,longitudinal diameter,internal echo,posterior echo and axillary lymph nodes enlargement or not between groups(all P<0.05).Mixed internal echo was an independent risk factor,while posterior attenuation was an independent protective factor for EPC(both P<0.05).Both the coincidence rate of biopsy pathology to postoperative pathology and axillary lymph node metastasis rate showed by postoperative pathology in EPC group were lower than those in IBC-NST group(both P<0.05).Conclusion Compared with IBC-NST,EPC ultrasound often showed relatively larger lesions,mixed internal echo(cystic-solid),enhanced or not changed posterior echo and fewer axillary lymph node metastases.