乳腺癌X线表现与不同分子亚型的相关性研究
发布时间:2018-06-13 12:04
本文选题:乳腺肿瘤 + 乳腺X线摄影 ; 参考:《青岛大学》2017年硕士论文
【摘要】:目的:对比分析不同分子亚型乳腺癌的X线摄影表现,探讨乳腺癌X线摄影表现与不同分子亚型之间的相关性。材料与方法:回顾性分析经手术病理证实的3909例乳腺癌患者的X线摄影资料及免疫组织化学资料,分析总结乳腺癌X线摄影病变的类型,包括单纯肿块、单纯钙化、肿块伴钙化、结构扭曲、局部致密及阴性征象;肿块型病变分析其形态、边缘、密度,钙化分析其形态及分布。根据免疫组织化学指标雌激素受体(Estrogen Receptor,ER)、孕激素受体(Progesterone Receptor,PR)、人类表皮生长因子受体2(Human Epidermal Growth Factor Receptor 2,简称Her-2)及细胞增殖指数Ki-67分四个亚型:Luminal A型:ER和/或PR(+)、Her-2(-)、Ki-6714%;Luminal B型:(1)ER和/或PR(+)、Her-2(-)、Ki-67≥14%;(2)ER和/或PR(+)、Her-2(+);Her-2过表达型:ER(-)、PR(-)、Her-2(+);Basal-Like型:ER(-)、PR(-)及Her-2(-)。采用Pearsonc2检验或Yates连续性校正c2检验,对不同分子亚型乳腺癌的X线摄影病变类型、肿块特征及钙化特征进行统计学分析,P0.05差异有统计学意义。结果:1.乳腺癌X线摄影病变类型与不同分子亚型的相关性:Luminal A型乳腺癌表现为单纯肿块的比例大于Luminal B型及Her-2过表达型(P0.001),Basal-Like型乳腺癌表现为单纯肿块的比例大于Luminal B型及Her-2过表达型(P0.001),差异均有统计学意义;Luminal A型乳腺癌表现为肿块伴钙化的比例小于其他三个亚型(P0.05),差异均有统计学意义;Her-2过表达型乳腺癌表现为单纯钙化的比例大于其他三个亚型(P0.05),表现为肿块伴钙化的比例大于其他三个亚型(P0.001),表现为局部致密的比例大于其他三个亚型(P0.05),差异均有统计学意义。2.乳腺癌肿块特征与不同分子亚型的相关性:Basal-Like型乳腺癌表现为类圆形肿块的比例大于其他三个亚型(P0.05),不规则肿块的比例小于其他三个亚型(P0.05),差异均有统计学意义;Luminal A型乳腺癌表现为毛刺状边缘的比例大于其他三个亚型(P0.05),边缘模糊的比例小于其他三个亚型(P0.05),差异均有统计学意义;Luminal A型乳腺癌表现为高密度肿块的比例小于其他三个亚型(P0.05),差异均有统计学意义。3.乳腺癌钙化特征与不同分子亚型的相关性:Luminal A型乳腺癌表现为不定形钙化的比例大于Her-2过表达型及Basal-Like型(P=0.003、P=0.007),表现为多形性钙化的比例小于其他三个亚型(P0.05),差异均有统计学意义;Luminal A型乳腺癌表现为不均质钙化的比例大于Luminal B型及Her-2过表达型(P0.001、P=0.019),差异均有统计学意义;Her-2过表达型乳腺癌钙化成簇分布的比例小于其他三个亚型(P0.05),差异均有统计学意义。结论:乳腺癌X线摄影表现与不同分子亚型之间存在一定的相关性。乳腺癌X线摄影表现对其分子亚型具有一定的预测作用,可为乳腺癌的临床诊治及预后评估提供一定的参考依据。
[Abstract]:Objective: to compare and analyze the X-ray findings of breast cancer with different molecular subtypes, and to explore the correlation between X-ray findings and different molecular subtypes of breast cancer. Materials and methods: the X-ray and immunohistochemical data of 3909 patients with breast cancer confirmed by surgery and pathology were analyzed retrospectively, and the types of X-ray lesions of breast cancer, including simple mass and calcification, were analyzed and summarized. Mass with calcification, structure distortion, local density and negative signs, mass lesion analysis of its shape, edge, density, calcification analysis of its morphology and distribution. According to the immunohistochemical indexes, estrogen receptor Estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, human epidermal growth factor receptor 2 (Her-2) and the cell proliferation index Ki-67, four subtypes: Luminal A, ER and / or PRA (Her-2Ca-Ki Ki-6714K), Luminal B: 1ER and / or PR1, the proliferative index Ki-67 subtypes of human epidermal growth factor receptor 2, and the cell proliferation index Ki-67 subtypes of ER and / or PR1. Or PRA (Her-2KI-67 鈮,
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