乳腺黏液癌影像学特征与病理分型相关性分析

发布时间：2018-02-27 21:03

本文关键词： 乳腺癌粘液癌 X线摄影 MRI 病理学　出处：《临床放射学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨乳腺黏液癌(BMC)的影像学表现与病理学分型的相关性。方法回顾性分析35例病理证实为乳腺BMC的X线及MRI资料(34例行X线检查,17例行MRI扫描),并与病理学结果相对照。结果 (1)35例BMC患者中,病理分型为单纯型28例,混合型7例;Luminal A型30例,Luminal B型及HER-2过表达型各2例,Basal-like型1例。(2)在34例BMC患者的X线图像上,29例表现为肿块样病灶,3例为非对称性致密,2例无异常发现;且55.2%(16/29)的肿块样病灶边缘可见小分叶,34.5%(10/29)的肿块样病灶边缘显示不清。分析32例MBC患者X线阳性表现与病理类型及分子亚型相关性,二者在病灶形态学特征(包括密度、形状及边缘)、钙化方面均无统计学意义(P均0.05)。(3)在17例患者MRI图像上,病灶在T2WI图像上呈明显高信号,11例病灶边缘可见小分叶,5例边界不清;增强后17例患者均发现肿块样病灶,8例患者表现为边缘环状强化,2例无强化。分析其与病理分型的相关性,在病灶形状、T2信号、病灶边界、内部增强形式、时间信号曲线及淋巴结转移方面均无统计学意义。(4)BI-RADS分类为5类,在乳腺X线摄影(41.2%,14/34)及MRI检查(35.3%,6/17)中所占的比例最大;若BI-RADS 4b认为是可疑恶性病灶,乳腺X线摄影及MRI诊断BMC的误诊率分别为35.3%(12/34)和29.4%(5/17)。结论 BMC病理分型以单纯型及Luminal A型多见,且不同病理分型的BMC影像学表现有所不同,但二者没有明显的相关性。X检查可作为BMC首选的检查方法,但最终诊断仍需结合临床病理。
[Abstract]:Objective to investigate the correlation between imaging findings and pathological classification of breast mucinous carcinoma (BMC). Methods 35 cases of pathologically proved breast BMC and 34 cases of MRI were retrospectively analyzed. Results in 35 patients with BMC, Pathological classification was simple type in 28 cases, mixed type in 30 cases of luminal B type and HER-2 overexpression type in 2 cases. On X-ray images of 34 cases of BMC, 29 cases showed tumor-like lesions in 3 cases. The margin of the tumor-like lesions in 55.2% and 16% 29) was not clear in the margin of small lobular lesions (34.55-10 / 29). The positive X-ray findings of 32 patients with MBC were correlated with the pathological types and molecular subtypes, and the morphological features (including density) of the lesions were analyzed. There was no statistical significance in the shape and edge of the lesion and calcification (P < 0.05). On MRI images of 17 cases, the lesions were obviously hyperintense on T _ 2WI images. In 11 cases, the margin of the lesions was obviously hyperintense. In 5 cases, the margin of small lobes was not clear. After enhancement, 8 cases of tumor-like lesions were found to be marginal circular enhancement in 2 cases without enhancement. The correlation between enhancement and pathological classification was analyzed, and the shape of T 2 signal, the margin of lesion, and the internal enhancement form were analyzed in the lesion shape, the shape of T 2 signal, the edge of the lesion, and the internal enhancement form. There was no statistical significance in time signal curve and lymph node metastasis. BI-RADS was classified into 5 categories, which accounted for the largest proportion in mammography (41.214 / 34) and MRI (35.3% / 17). If BI-RADS 4b was considered to be a suspicious malignant lesion, The misdiagnosis rate of BMC diagnosed by mammography and MRI was 35.312 / 34) and 29.4 / 17 respectively. Conclusion the pathological types of BMC are simple type and Luminal A type, and the imaging manifestations of BMC are different among different pathological types. But there is no obvious correlation between them. X examination can be used as the first method of BMC, but the final diagnosis should be combined with clinicopathology.
【作者单位】：郑州大学第一附属医院放射科;
【分类号】：R445.2;R730.44;R737.9

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