沈丽丽

【摘要】 目的：研究乳腺癌患者超聲征象与其病理组织学类型之间的相关性。方法：以回顾性研究纳入2020年1月—2022年1月南通市第一人民医院收治的70例乳腺癌患者的临床资料，均于治疗前行彩色多普勒超声检查，于治疗后行组织病理学检测。统计患者的一般资料，对不同病理组织学类型[乳腺浸润性小叶癌（ILC）、乳腺浸润性导管癌（IDC）]、分级（低分化、中高分化）患者的超声征象（肿块形态、毛刺征、高回声晕、后方回声、微小钙化、血流）进行比较分析。结果：70例患者组织学分类为IDC 45例、ILC 25例。组织学分化等级为低分化者32例、中高分化者38例。IDC患者中的肿块形态不规则比例低于ILC患者，微小钙化比例高于ILC患者，差异均有统计学意义（P<0.05）；低分化乳腺癌患者的肿块形态不规则比例、微小钙化比例、血流丰富比例均高于中高分化乳腺癌患者，差异均有统计学意义（P<0.05）。结论：乳腺癌患者超声检查中的肿块形态不规则、微小钙化征象与其病理组织学类型和分级均有一定关系，血流丰富征象对判断乳腺癌患者的病理组织学分类亦有积极作用。

【关键词】 乳腺癌 超声检查 超声征象特征 病理组织学 肿块形态 钙化

Correlation Analysis between Ultrasonic Signs and Histopathological Types in Patients with Breast Cancer/SHEN Lili. //Medical Innovation of China， 2024， 21（08）： -156

[Abstract] Objective： To study the correlation between ultrasonic signs and histopathological types in patients with breast cancer. Method： A retrospective study was conducted on clinical data of 70 patients with breast cancer admitted to Nantong First People's Hospital from January 2020 to January 2022 were examined by color Doppler ultrasound before treatment and histopathology after treatment. General information of patients were counted， and the ultrasound signs （tumor morphology， hairpin sign， hyperechoic halo， posterior echo， microcalcifications， and blood flow） of patients with different histopathological types [infiltrating lobular carcinoma of the breast （ILC） and invasive ductal carcinoma of the breast （IDC）] and grading （low differentiation， medium to high differentiation） were compared and analyzed. Result： The histological classification of 70 patients was IDC in 45 cases and ILC in 25 cases. There were 32 cases with low differentiation and 38 cases with medium to high differentiation in histological differentiation. The proportion of mass morphology in IDC patients was lower than that in ILC patients， and the proportion of microcalcifications was higher than that in ILC patients， the differences were statistically significant （P<0.05）; the proportion of mass morphology， microcalcification and rich blood flow in poorly differentiated breast cancer patients were higher than those in moderately well differentiated breast cancer patients， the differences were statistically significant （P<0.05）. Conclusion： The irregularity of mass morphology and signs of microcalcifications on ultrasonography in patients with breast cancer are related to both their pathohistologic type and grading， and the signs of rich blood flow also play an active role in judging the histopathological classification of breast cancer patients.

[Key words] Breast cancer Ultrasound examination Ultrasound signs features Pathological histology Tumor morphology Calcification

First-author's address： Department of Ultrasound， Nantong First People's Hospital， Nantong 226001， China

doi：10.3969/j.issn.1674-4985.2024.08.034

乳腺癌作为当前临床常见的一项恶性肿瘤疾病，统计显示世界范围内乳腺癌已经取代肺癌成为最常见的恶性肿瘤，其死亡人数位居全球女性恶性肿瘤死亡人数的首位[1]；中国范围内乳腺癌发病率亦位居女性恶性肿瘤发病谱的首位[2]，每年新发病数量约为41.6万，占全球病例18.4%的同时，年龄标化发病率为36.1/（10万）而死亡率为8.8/（10万）[3]。基于乳腺癌的高发病率及高威胁性，做好乳腺癌的早期筛查、诊治等干预工作对保障人民群众的生命安全有重要意义。超声检查作为当前临床对乳腺癌诊断时的一项基础检查技术，临床研究证实乳腺癌患者的超声声像图特征与其病理学分级、分子水平等均有密切关系，可通过患者超声特征观察其病理学及免疫学化学因素的变化[4-5]。……