乳腺黏液腺癌的钼靶X线表现与病理对照研究

Mammographic features of breast mucinous carcinoma: mammographic-pathologic correlation

目的 研究乳腺黏液腺癌的钼靶X线表现的病理基础。方法 回顾性分析 2 1例乳腺黏液腺癌的钼靶X线表现 ,与病理分型 (16例单纯型、5例混合型 )对照 ;单纯型肿瘤组尚与不同肿瘤黏液量 (少黏液量组、多黏液量组 )进行对照。结果 (1)乳腺黏液腺癌最常见的钼靶X线表现为肿块 (15例 )和肿块伴钙化 (2例 )。少见征象如局灶性致密病变和单纯钙化各 1例 ,阴性表现 2例 ,均为单纯型多黏液量组病变。 (2 )表现为肿块的 17例黏液腺癌中 ,混合型的钼靶X线表现为浸润性边缘(5 /5 ) ;单纯型多表现为小分叶边缘及清晰边缘 (7/12 )。 (3 )表现为肿块的单纯型黏液腺癌中 ,多黏液量组多数为小分叶状边缘 (4 /7) ;而少黏液组多呈浸润性边缘 (3 /5 )。 (4 )密度改变在判断黏液腺癌的病理分型及对黏液量的判断上差异无显著意义 (P值均 >0 0 5 )。结论 不同亚型的乳腺黏液腺癌的钼靶X线表现不完全一致 ,多黏液量单纯型黏液腺癌最常见的表现为小分叶状边缘肿块 ;

Objective To correlate the mammographic features of breast mucinous carcinoma with pathologic types and mucin rates. Methods The mammographic features of breast mucinous carcinoma in 21 cases were retrospectively studied, and then correlated with pathologic findings (including 16 pure and 5 mixed type). The volume of extracellular mucin of pure type mucinous carcinomas was re-estimated and compared with the mammographic features. Results (1)The most frequent mammographic feature of mucinous carcinoma was the mass (15 lesions) and the mass with calcifications (2 lesions). Seldom features, such as focal asymmetric opacity and pleomorphic calcifications only (1 lesion respectively), as well as occult mammogram (2 lesions) were all seen in pure type of carcinomas with high percentages of mucin. (2)The mass appeared in 17 lesions. The mixed type mucinous carcinomas demonstrated poorly defined margins (5/5). The well-defined, lobulated margins (7/12)of the mass were correlated with pure histologic type. (3)In the pure type mucinous carcinomas, the most high volume mucin tumors appeared with lobulated margins (4/7), whereas the tumors with small volume mucin appeared with poorly defined margins (3/5). (4)The density of the mass was not correlated with pathologic types and mucin rates (P>0.05,respectively. Chi-square test, Fisher′s exact method). Conclusion The mammographic features of mucinous breast carcinoma show differences in pure and mixed types of the tumor. The most common mammographic appearance of pure mucinous carcinomas with high volume of mucin is a mass with microlobulated margins. Pure type of carcinomas with small volume of mucin and mixed type carcinomas have more aggressive imaging characteristics.