乳腺癌X线毛刺征的病理学基础探讨

Spicular signs of breast cancer: mammographic and pathological study

目的 :探讨乳腺癌X线毛刺征形态学特点及其病理学基础。方法 :回顾性分析 5 1例具毛刺征的乳腺癌X线和病理学表现。所有病例均具备完整的X线摄片和病理切片资料。结果 :X线上乳腺癌肿块具备长毛刺征 6例 ,短毛刺征 3 0例 ,星状影 15例。病理学上 ,肿块毛刺成分均匀者 2 3例 ,不均匀 13例 ;而星状影则为 5例、10例 ;肿块周边胶原纤维活性按低到中度和高度划分 ,长毛刺征为 6例、0例 ,短毛刺组征为 2 4例、6例 ,星状影为 12例、3例 ;肿块周边呈浸润扩散改变 ,长毛刺征 3例 ( 5 0 %) ,短毛刺征 2 7例 ( 90 %) ,星状影 12例 ( 80 %)。毛刺内伴钙化 12例 ,均在癌浸润扩散基础上发生。结论 :乳腺癌肿块边缘 ,癌浸润扩散是X线上毛刺征形成的主要病理学基础。毛刺内伴钙化是乳腺癌重要的恶性X线征象。

Objective:To investigate spicular sign of breast cancer on the mammography with pathological correlation.Methods:Mammography of 51 cases of breast cancer were retrospectively analyzed with correlation to pathology.Results:Long spicules were present in 6 cases,short spicules in 30,and stellar sign in 15.Histopathologically,tumor cells and fibrous stroma mixed evenly and unevenly in breast cancers with long and short spicules were respectively 23 cases and 13 cases.Tumor cells and fibrous stroma mixed evenly and unevenly in stellar sign were 5 and 10, respectively.Low middle and high level of fibrous hyperplasia in marginal region of the tumor were 6 and 0 in long spicules,respectively;24 and 6 in short spicules,respectively;12 and 3 in the stellar tumor,respectively.Infiltration and invasion at the edge of the tumor were detected in 3(50%) of tumors with long spicules,27(90%) of short spicules and 12(80%) of stellar sign.Calcifications within the spicules were present in 12 cases due to infiltration of tumors.Conclusion:The most important cause of spicule development is malignant infiltration and involvement.Calcifications within spicule strongly indicate malignancy.