乳腺导管原位癌超声声像图与组织病理分级的相关性研究

发布时间：2020-08-10 14:40

【摘要】：目的:探讨彩色多普勒高频超声检查对乳腺导管原位癌(ductal carcinoma in situ,DCIS))的诊断、实用价值,分析其病灶超声表现与病理分级相关性,以期为DCIS患者制定合理、全面、个体化治疗方案提供可靠的超声诊断依据。方法:运用回顾性分析方法,对在我院行手术并病理证实的132例乳腺DCIS患者超声声像图特征性表现进行研究。根据乳腺X线恶性钙化的有无,可分为无恶性钙化组及有恶性钙化组。超声声像图表现大致可分为:超声检查阴性、肿块型、单纯导管扩张型、导管扩张伴其内肿块形成型、片状不均质/低回声区。从而研究不同病理级别的DCIS与超声声像图表现的相关性。结果:132例DCIS患者中,恶性钙化组、非恶性钙化组分别为69例(52.3%)、63例(47.7%),两组乳腺超声声像图表现各自分为:肿块型31例(23.5%)与37例(28.0%)、单纯导管扩张型5例(3.8%)与2例(1.5%)、导管扩张伴其内肿块形成型5例(3.7%)与7例(5.3%)、片状不均质/低回声区20例(15.2%)与12例(9.1%)、阴性8例(6.1%)与5例(3.8%)。超声检查在形态、边界、内部回声、血流情况与病理分级相关(r=-0.301、-0.283、-0.286、-0.284,P0.005),高级别与恶性钙化组肿块型、片状不均质/低回声区型相关(r=0.287、0.271,P0.005),中级别与恶性钙化组导管扩张并其内肿块形成型相关(r=0.309,P0.05),低级别与非恶性钙化组肿块型、阴性相关(r=0.265、0.271,P0.05)。结论:DCIS超声声像图和病理分级具有相关性,超声检查对优化治疗DCIS这种有浸润发展潜力的疾病有重要意义。
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2018
【分类号】：R445.1;R737.9
【图文】：

等密度,象限,肿块,乳腺超声

38附录图2 乳腺X线检查示左乳外上象限见多发大小不等等密度圆形肿块，肿块考虑为导乳瘤可能。Fig.2Mammography showed multiple round masses of different size and equal density in theupper quadrant of the left mammary gland. The mass may be considered as intraductalpapilloma .图3、4 乳腺超声检查示左乳外上多房囊性肿物，界清、不规整，回声不均匀，考虑增生灶合并导管扩张。病理为低级别DCIS。Fig.3、4 Breast ultrasonography showed multiple cystic masses in the left superior mammarygland, with clear boundary, irregular and uneven echo, considering hyperplastic foci combinedwith ductal dilatation.Its pathology is low grade DCIS.

乳腺超声,回声,不均匀,病理

upper quadrant of the left mammary gland. The mass may be considered as intraductalpapilloma .图3、4 乳腺超声检查示左乳外上多房囊性肿物，界清、不规整，回声不均匀，考虑增生灶合并导管扩张。病理为低级别DCIS。Fig.3、4 Breast ultrasonography showed multiple cystic masses in the left superior mammarygland, with clear boundary, irregular and uneven echo, considering hyperplastic foci combinedwith ductal dilatation.Its pathology is low grade DCIS.

多形性,细线,下限,分支

新疆医科大学硕士学位论文39图5 乳腺X线检查，右乳外下限多发成簇细小多形性钙化及细线分支样钙化。考虑为乳腺癌。Fig.5Mammogram examination showed multiple clusters of small pleomorphic calcifications andfine branched calcifications in the lower and outer limits of the right mammary gland. It isconsidered for breast cancer.图6、7 乳腺超声示右乳外下不规整片状低回声区，回声不均，病理示高级别DCIS.Fig.6、7Breast ultrasound showed irregular submammary hypoechoic area with uneven echo andhigh grade DCIS by pathology.

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