乳腺病灶硬度不同的病理基础研究

发布时间：2018-04-19 10:59

本文选题：乳腺病灶 + 硬度　；参考：《中国超声医学杂志》2017年01期

【摘要】：目的通过研究不同性质乳腺病灶弹性大小与组织胶原纤维形态排列特点的关系,探讨形成病灶不同硬度的可能原因。方法选择54例经过手术切除、病理证实的乳腺良恶性实性病灶作为研究对象,分析每一个病灶间质胶原纤维形状和排列特点,并给予分类,总结各类别病灶的最大弹性值与胶原纤维形态排列的关系。结果 54例乳腺病灶,良性18例,恶性36例;从胶原形态上来看,恶性病灶中有35例表现为长直,良性中有8例表现为短弯;45例表现为长直的平均Emax为(109.2±62.4)kPa,9例表现为短弯的平均Emax为(23.9±20.9)kPa,二者差异显著(P=0.000);从胶原排列上,36例恶性表现为蜂窝、成片、分层和无特定等多种方式,其中无特定方式9例,18例良性中表现无特定方式的有16例;胶原纤维表现为蜂窝状的弹性值高于其他排列的弹性值(P0.05);同为恶性病灶的病例中,每种排列方式的平均Emax之间具有显著差异(P=0.001)。结论乳腺病灶间质内不同的胶原纤维形态排列形成病灶不同的硬度,乳腺良恶性病灶的硬度相近是胶原纤维形态排列交叉混组导致;长直形态、蜂窝状排列的胶原纤维是乳腺浸润性导管癌明显变硬的原因。
[Abstract]:Objective to study the relationship between the elastic size of different types of breast lesions and the morphological characteristics of collagen fibers, and to explore the possible causes of different hardness of the lesions.Methods 54 cases of breast benign and malignant solid lesions confirmed by surgery and pathology were selected as the study objects. The shape and arrangement of collagen fibers in the stroma of each lesion were analyzed and classified.To summarize the relationship between the maximum elastic value of various types of lesions and the morphological arrangement of collagen fibers.Results 54 cases of breast lesions, 18 cases of benign, 36 cases of malignant, from the collagen morphology, 35 cases of malignant lesions showed long straight,In the benign cases, the average Emax was 109.2 卤62.4 kPa.The average Emax of 9 cases with short curvature was 23.9 卤20.9kPa.The difference between the two was significant (P = 0.0000.000), and 36 cases of malignant lesions showed honeycomb, lamellar, stratification and no specific patterns in collagen arrangement.Of the 18 benign cases with no specific mode, 16 cases showed no specific pattern; the elastic value of collagen fibers was higher than that of other arranged elastic values (P 0.05); in the same malignant lesions, 16 cases were malignant lesions.There was significant difference between the average Emax of each arrangement.Conclusion the morphology of collagen fibers in the stroma of breast lesions forms different hardness of the lesions. The hardness of benign and malignant breast lesions is similar to that of the cross mixing group of collagenous fibers.Honeycombed collagen fibers are the cause of obvious hardening of invasive ductal carcinoma of the breast.
【作者单位】：解放军总医院南楼超声科;北京友谊医院超声科;解放军总医院病理科;
【基金】：国家自然科学基金专项(No.81241055)
【分类号】：R445.1;R655.8

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