宋巍 姚虹 王罡

摘要：目的  分析乳腺癌的主要X线征象，肿块、局限性致密浸润影与病理检测常用的免疫组化标记物ER，PR，C-erbB-2，nm23之间的关系。方法  收集云南省第一人民医院2016年1月～2019年1月经病理证实107例乳腺癌患者作為研究对象，病灶共108例，所有患者均行钼靶X线摄影。根据X线征象将所有病灶分为肿块组73例及局限性致密影组35例。使用免疫组化技术测定乳腺癌ER，PR，C-erbB-2，nm23的表达水平，比较两组癌灶中基因表达水平。结果  乳腺癌钼靶X线征象表现为局限性致密浸润影组（80.00%）C-erbB-2的表达高于肿块组（56.16%），差异有统计学意义（P<0.05）;局限性致密浸润影组（40.00%）nm23高表达者低于肿块组（64.38%），差异有统计学意义（P<0.05）;局限性致密浸润影组腋窝淋巴结转移多于肿块组（P<0.05）;肿块和局限性致密浸润影其ER，PR阳性表达比较，差异均无统计学意义（P>0.05）。结论  乳腺癌主要X线征象的差异可反映肿瘤细胞基因表达C-erbB-2与nm23水平，针对乳腺癌具体征象分析对于其早期诊断及其预后的初步判断有一定意义。

关键词：乳腺癌;肿块;局限性致密浸润影;免疫组化标记物

中图分类号：R737.9                                文献标识码：A                                  DOI：10.3969/j.issn.1006-1959.2019.18.019

文章编号：1006-1959（2019）18-0059-04

Abstract：Objective  To analyze the relationship between the main X-ray signs of breast cancer， tumors， localized dense infiltrates and immunological standardization markers ER， PR， C-erbB-2， nm23 commonly used in pathological examination.Methods  A total of 107 patients with breast cancer were enrolled in the First People's Hospital of Yunnan Province from January 2016 to January 2019. The lesions were 108 patients. All patients underwent mammography. According to X-ray signs， all lesions were divided into 73 cases of mass group and 35 cases of localized dense shadow group. The expression levels of ER， PR， C-erbB-2 and nm23 in breast cancer were determined by immunohistochemistry， and the gene expression levels in the two groups were compared. Results  The mammography of mammography showed that the expression of C-erbB-2 was higher in the localized dense infiltration group （80.00%） than in the mass group （56.16%），the difference was statistically significant （P<0.05）; localized dense In the infiltration group （40.00%）， the high expression of nm23 was lower than that of the mass group （64.38%）， the difference was statistically significant （P<0.05）; the localized dense infiltration group had more axillary lymph node metastasis than the mass group （P<0.05）; There was no significant difference in the positive expression of ER and PR between the lumps and localized dense infiltrates （P>0.05）.Conclusion  The difference of main X-ray signs of breast cancer can reflect the expression of C-erbB-2 and nm23 in tumor cells. The analysis of specific signs of breast cancer has certain significance for the early diagnosis and prognosis.

Key words：Breast cancer;Mass;Localized dense infiltrates;Immunohistochemical markers

乳腺癌（breast cancer，BC）是严重威胁妇女生命健康的恶性肿瘤。目前乳腺癌的诊断主要依靠临床体征、钼靶X线摄影、脱落及穿刺细胞学检查和病理切片（包括病理形态及免疫组化）[1-4]综合诊断，而从基因水平研究乳腺癌的临床特征，尤其是影像学表现与基因水平关系的研究，正是当前乳腺癌诊治的热点[5]。本研究初步探讨了乳腺癌的两种常见主要钼靶X线征象，肿块及局限性致密浸润影与临床常用的免疫组化标记物ER，PR，C-erB-2，nm23之间的关系，以期为乳腺癌的早期诊断及预后的初步判断提供依据。

1资料与方法

1.1一般资料  收集云南省第一人民医院/昆明理工大学附属昆华医院2016年1月～2019年1月共107例患者，108例病灶资料。……