目的 分析超声各特征性影像表现在乳腺浸润性导管癌中的诊断价值。方法 选取解放军总医院第六医学中心 2018-01至2019-12两年内收治的 135例乳腺浸润性导管癌患者纳入本研究,分析乳腺浸润性导管癌的超声影像特征、体检自检发现率以及淋巴结转移与病变大小、位置的相关性。结果 (1)单因素分析显示:形态不规则(91.11%)、边界不清楚(64.44％)、血流信号(44.44％)、微钙化(37.78%)、纵横比＞1(17.78％)、后方回声衰减(15.56％)超声诊断指标,与浸润性导管癌的诊断具有相关性;(2)与其他三个象限相比较,内上象限浸润性导管癌更容易被患者自检发现,占自检发现病例的34.93%;(3)内上象限及外上象限的浸润性导管癌更容易发生淋巴结转移(转移率为:内上:25.53%,内下:0.00%,外上:64.70%,外下:11.76%);(4)对＜3 cm的浸润性导管癌,其大小与腋窝淋巴结的转移没有相关性。结论 超声表现以形态不规则在乳腺浸润性导管癌中的发生率最高,且在早期病变中即表现出来;乳腺病变的自检检出率、乳腺癌淋巴转移率均与乳腺病变的大小和位置密切相关。
Abstract
Objective To analyze the diagnostic value of each characteristic ultrasound image in breast invasive ductal carcinomas.Methods One hundred and thirty-five patients with invasive ductal carcinomas of the breast admitted to our hospital between January 2018 and December 2019 were included in this study to analyze the characteristics of ultrasound image of breast infiltrating ductal carcinomas, the detection rate of self-examination and the correlations between lymph node metastasis and lesion size and location.Results (1)Singe factor analysis showed that such ultrasound imaging features as an irregular shape (91.00%), unclear borders (91.00%), blood flow signals (77.78%), microcalcification (55.56%), aspect ratio>1 (26.67%), and posterior echo attenuation (15.50%) were correlated with the diagnosis with invasive ductal carcinomas.(2)Invasive ductal carcinomas in the inner and upper quadrants were more likely to be detected by the patient's self-examinationthan the other three quadrants, accounting for 54.00% of the cases detected by self-examination.(3)Infiltrating ductal carcinomas in the inner and upper quadrants were more prone to lymph node metastasis (metastasis rate: inner upper: 36.40%, inner lower: 0%, outer upper: 50.00%, outer lower: 16.67%).(4)The size of invasive ductal carcinomas was not related to the metastasis of axillary lymph nodes.Conclusions Ultrasound has a strong ability to detect breast lesions. An irregular shape in the ultrasound image is most likely to be a sign of an invasive ductal carcinoma of the breast, and it is manifested in early lesions. The self-detection rate of breast lesions and the lymphatic metastasis rate of breast cancer are closely related to the size and location of breast lesions.
关键词
乳腺 /
浸润性导管癌 /
彩色多普勒超声
Key words
breast /
invasive ductal carcinoma /
color Doppler ultrasound
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 李俊来,赵晓慧.正常乳腺组织结构与超声表现[J].中华医学超声杂志(电子版),2017,14(8):561-566.
[2] 李俊来.乳腺超声BI-RADS分类应用价值和建议[J].中华医学超声杂志(电子版),2015,12(11):828-833.
[3] Li T, Mello T C, Brennan P C. Descriptive epidemiology of breast cancer in China: incidence, mortality, survival and prevalence[J]. BREAST CANCER RES TR,2016, 159(3):395-406.
[4] Bray F,Ferlay J,Soerjomataram I,et al.Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36cancers in 185 countries[J].CA Cancer J Clin,2018,68(6):394-424.
[5] Ozmen N, Dapp R, Zapf M. Comparing different ultrasound imaging methods for breast cancer detection[J]. IEEE,2015, 62(4):637-646.
[6] Shi J, Wang R, Zhou S.The research progress of breast ultrasound CAD with breast imaging and reporting data system[J]. Sheng wu yi xue gong cheng xue za zhi,2010, 27(5):1169-1172.
[7] Li Y, Zhang N, Zhang H. Comparative prognostic analysis for triple negative breast cancer with metaplastic and invasive ductal carcinoma[J]. J clini pathol,2019,72(6):418-424.
[8] Wang X, Li L, Gao J. The association between body size and breast cancer in han women in northern and eastern China[J]. The oncologist,2016, 21(11):1362-1368.
[9] Masroor I, Afzal S, Sufian S. Imaging guided breast interventions. journal of the college of physicians and surgeons Pakistan[J].JCPSP,2016, 26(6):521-526.
[10] Sheth D, Abe H: Abbreviated MRI and Accelerated MRI for Screening and Diagnosis of Breast Cancer. Topics in magnetic resonance imaging[J]. TMRI,2017,26(5):183-189.
[11] Ha R, Kim H, Mango V. Ultrasonographic features and clinical implications of benign palpable breast lesions in young women[J]. Ultrasonography,2015, 34(1):66-70.
[12] Sadoughi F, Kazemy Z, Hamedan F. Artificial intelligence methods for the diagnosis of breast cancer by image processing: a review[J]. Breast cancer,2018, 10(4):219-230.
[13] Alamo L, Fischer U.Contrast enhanced color doppler ultrasound characteristics in hypervascular breast tumors[J]. Eur radiol, 2001, 11(6):970-977.
[14] Dogra A,Doval D C,Sardana M.Clinicopathological characteristics of triple negative breast cancer at a tertiary care hospital inIndi[J]. Asian Pac J Cancer Prev, 2014,15( 24 ): 10577-10583.
[15] 李 毅,吕艳丽,赵 越,等.超声和X线检查对乳腺病变的诊断效能分析[J].中华乳腺病杂志(电子版),2016,10(5):295-299.
PDF(618 KB)
