中晚期乳腺癌术前化疗前后的X线改变（附25例报告）.docVIP

精品论文 参考文献 中晚期乳腺癌术前化疗前后的X线改变（附25例报告） 刘凤梅　汤发　(广西桂林市中医医院放射科　广西桂林　541002) 【中图分类号】R737.9【文献标识码】A【文章编号】1672-5085（2011）44-0056-03 【摘要】目的 观察分析乳腺癌术前化疗前后的X线影像改变。方法　25例经穿刺病理证实中晚期乳腺癌的病例，术前经1至6个月化疗，化疗前后均做X线检查。结果　①病灶呈肿块影21例，病灶呈片状影4例；②化疗后肿块或病灶明显缩小22例，不变2例，增大1例；③化疗后钙化灶显示更清晰12例，毛刺征更明显18例, 水肿环影增宽16例；④腋下淋巴结缩小11例。结论　乳腺癌术前化疗可提高手术可行性和延长生存期的有效方法，X线检查是监测化疗效果的有效检查。 【关键词】乳腺癌　术前化疗　X线表现 Preoperative chemotherapy in advanced breast cancer before and after X-ray changes(report of 25 cases) Liu Fengmei Tangfa. （Guilin Chinese Medicine Hospital Department of Radiology， 541002) 【Abstract】 Objective: Observed and analyzed before and after preoperative chemotherapy in breast cancer X-ray changes.　Methods: 25 cases confirmed by biopsy in cases of advanced breast cancer, Preoperatively for 1 to 6 months of chemotherapy, chemotherapy before and after the X-ray examination done.　　Results: ① lesions were mass in 21 cases, 4 cases of lesions in flaky film; ② after chemotherapy significantly reduced tumor or lesion in 22 cases, unchanged in 2 cases, 1 case of increased; ③ after chemotherapy showed calcification in 12 cases more clearly, Spiculation more obvious in 18 cases, 16 cases of edema and ring shadow widened; ④ reduced axillary lymph nodes in 11 cases. Conclusion: The preoperative chemotherapy in breast cancer surgery can improve the feasibility and effective way to prolong survival, X-ray examination is to monitor the effect of chemotherapy and effective inspection.　　 【Key words】 breast cancer preoperative chemotherapy X-ray 乳腺癌是妇女最常见的恶性肿瘤之一，其发病率占女性恶性肿瘤之首位，其中中晚期乳腺癌的治疗更是棘手的问题，术前化疗已成为中晚期乳腺癌治疗的有效方法。收集广西桂林市中医医院从2009年7月至2010年12月25例中晚期乳腺癌术前化疗前后的X线检查，对其影像改变进行分析。 1 资料与方法 1.1病例资料 25例均为女性，年龄27岁-57岁，中位年龄42岁，25例临床扪及较大病灶，部分病灶与胸壁粘连，化疗前均经穿刺病理证实中晚期乳腺癌，肿瘤最大径5.4～8.6cm，经１至６个月术前化疗，化疗药有吡柔比星，多西他赛，表阿霉素等，根据病人情况稍有调整。 1.2方法　病例化疗前后均接受X线检查，选择月经后检查，广西桂林市中医医院使用意大利GIOTTO牌高频钼靶乳腺X线机常规摄取乳腺轴位及斜位，必要时加照切线位片，全部病例经２名以上经验丰富的医生阅片。 2 结果 2.1 ２５例病灶有肿块影21例，病灶呈片状高密度影４例；化疗后肿块或病灶明显缩小22例（如图１a、１b