乳腺导管内癌X线表现与分子分型对照研究.docVIP

乳腺导管内癌的X线表现与分子分型的对照研究 　　[摘要] 目的 探?乳腺导管内癌的X线表现与分子分型的关系。 方法 回顾性分析133例136侧DCIS的X线表现及组织病理学、免疫组织化学结果。 结果 （1）136侧乳腺导管内癌X线表现为单纯钙化（32.4%）、钙化伴局灶性不对称/肿块（29.4%），钙化出现率61.8%。钙化形态以细小多形性（58.3%）、段样分布多见（54.8%）；形态分布组合以细小多形性钙化成簇分布多见。肿块的形态多为不规则形（62.5%）、边缘模糊（43.8%）、高密度（75%）。（2）DCIS以Luminal A型多见，Her-2过表达型次之。（3）ER/PR（+）、Her-2（-）X线表现单纯钙化多见35.6%、34.6%，形态为细小多形性68.6%、71.7%、成簇分布52.9%、52.2%；ER/PR（-）、Her-2过表达多表现为钙化伴局灶性不对称/肿块38.8%、36.2%，钙化形态前者为细小多形性57.6%、段样分布69.7%，后者为线样分支状52.6%、段样分布65.8%。（4）Ki-67增殖指数≤10%时，83.3%ER（+）、80.6%Her-2（-），钙化形态多为细小多形性（88.2%）；当Ki-67增殖指数31%时，56.4%ER（+）、48.7%Her-2（-），钙化形态为线样分支状48.3%。 结论 DCIS分子分型以Luminal A型多见。X线以钙化为主要表现，形态多为细小多形性、线样分支状；分布以段样及成簇多见。钙化的分布、形态及形态分布组合与ER、PR、Her-2及Ki-67增殖指数有关。 　　[关键词] 数字化乳腺X线摄影；癌；导管；激素受体；人表皮生长因子受体；分子分型 　　[中图分类号] R737.9 [文献标识码] A [文章编号] 2095-0616（2017）13-13-04 　　[Abstract] Objective To explore the relationship the X-ray appearance and molecule subtype of the Breast DCIS （Ductal Carcinoma In Situ，DCIS），in order to know more about them. Methods The main X-ray appearance，histopathology and immunhistochemistry of the 133 cases DCIS （all 136 latero-breast） were retrospectively analyzed. Results （1）The main X-ray appearance of the 136 laterals DCIS were calcification 32.4%，calcification with focal dissymmetry/mass 29.4%，the frequency of calcification of all cases was 61.8%.The main morphous and distribution of calcifications was fine pleomorphic calcifications 58.3% and segmental 54.8% respectively，the main combination of morphous and distribution of calcifications was clustering fine pleomorphic calcifications.The appearance of the mass were irregular 62.5%，ambigutiy boundary 43.8%，high density 75%.（2）The molecule subtype of the Luminal A was the most frequent found in the different grade DCIS.（3）The main X-ray appearance of the ER/PR（+） and Her-2（-） DCIS were purely calcifications （35.6% vs 34.6%），the appearance of calcifications of them were fine pleomorphic calcifications （68.6% vs 71.7%），cluster（52.9% vs 52.2%）.However，the main X-ray appearance of