CAJ | 학술논문

目的比较三阴性乳腺癌[雌激素受体(ER)、孕激素受体(PR)和人类表皮生长因子受体2 (HER-2)均表达阴性]、ER+/PR +/HER-2 -型乳腺癌和ER-/PR-/HER-2+型乳腺癌的钼靶影像学表现和临床病理特征,探讨钼靶影像学表现和临床病理特征诊断三阴性乳腺癌的价值.方法收集临床资料完整的乳腺癌患者500例,其中三阴性乳腺癌患者112例,ER+/PR+/HER-2-型乳腺癌患者310例,ER-/PR-/HER-2+型乳腺癌患者78例.比较3组患者的钼靶影像学表现和临床病理特征.结果三阴性乳腺癌组与ER +/PR +/HER-2 -组比较,具有较高的病理组织学分级(P＜0.001).三阴性乳腺癌组钼靶X线检查多表现为肿物,其中单纯肿物占58.0％,肿物伴钙化占19.6％.三阴性乳腺癌组肿物边缘多表现为光滑(47.1％),高于ER +/PR +/HER-2 -组(9.8％,P =0.032)和ER-/PR-/HER-2+组(0,P=0.028).三阴性乳腺癌组钼靶X线检查较少表现为钙化,其中单纯钙化占13.4％,肿物伴钙化占19.6％.三阴性乳腺癌组钙化多为良性钙化(70.3％),明显高于ER +/PR +/HER-2-组(23.1％,P =0.002)和ER-/PR-/HER-2+组(10.2％,P＜0.001).结论不同类型的乳腺癌有不同的生物学特征,其钼靶影像学表现也不尽相同,乳腺癌的钼靶影像学特征可帮助临床医师预测乳腺癌类型和患者的预后,以及评估患者对各种治疗方法的敏感性,有利于制定最优的治疗方案.
목적 비교삼음성유선암[자격소수체(ER)、잉격소수체(PR)화인류표피생장인자수체2 (HER-2)균표체음성]、ER+/PR +/HER-2 -형유선암화ER-/PR-/HER-2+형유선암적목파영상학표현화림상병리특정,탐토목파영상학표현화림상병리특정진단삼음성유선암적개치.방법 수집림상자료완정적유선암환자500례,기중삼음성유선암환자112례,ER+/PR+/HER-2-형유선암환자310례,ER-/PR-/HER-2+형유선암환자78례.비교3조환자적목파영상학표현화림상병리특정.결과 삼음성유선암조여ER +/PR +/HER-2 -조비교,구유교고적병리조직학분급(P＜0.001).삼음성유선암조목파X선검사다표현위종물,기중단순종물점58.0％,종물반개화점19.6％.삼음성유선암조종물변연다표현위광활(47.1％),고우ER +/PR +/HER-2 -조(9.8％,P =0.032)화ER-/PR-/HER-2+조(0,P=0.028).삼음성유선암조목파X선검사교소표현위개화,기중단순개화점13.4％,종물반개화점19.6％.삼음성유선암조개화다위량성개화(70.3％),명현고우ER +/PR +/HER-2-조(23.1％,P =0.002)화ER-/PR-/HER-2+조(10.2％,P＜0.001).결론 불동류형적유선암유불동적생물학특정,기목파영상학표현야불진상동,유선암적목파영상학특정가방조림상의사예측유선암류형화환자적예후,이급평고환자대각충치료방법적민감성,유리우제정최우적치료방안.
Objective To retrospectively evaluate the mammographic imaging findings and pathologic changes of the so-called “triple-negative” breast cancer ( ER-/PR-/HER-2 - breast cancer),and to compare them with the ER+/PR+/HER-2- and ER-/PR-/HER-2+ breast cancer patients.Methods Five hundred cases of breast cancer treated in Cancer Institute and Hospital of Tianjin University from January to June of 2010 were included in this study.There were 112 cases of triple-negative breast cancer,310 cases of ER+/PR+/HER-2- breast cancer,and 78 cases of ER-/PR-/HER-2+ breast cancer.Their pathological and mammographic data were reviewed and analyzed. The pathological and mammographic features of the three groups were compared.Results Compared with the ER+/PR +/HER-2- breast cancer group,the triple-negative group had a higher histological grade (P ＜ 0.001 ).Compared with the ER +/PR +/HER-2- and ER-/PR-/HER-2 + groups,the triple-negative group was more likely to have a tumor mass (simple mass accounted for 58.0％,and tumor mass with calcification accounted for 19.6％ ).Moreover,compared with the ER +/PR +/HER-2 - group(47.1％ vs.9.8％,P =0.032) and the ER-/PR-/HER-2 + group(47.1％ vs.0,P =0.028),the tumor mass of triple-negative cancer was more likely to have a smooth margin.Triple-negative breast cancer seldom represented as calcification ( simple calcification only accounted for 13.4％,and a mass with calcification accounted for 19.6％ ),and most of them were benign calcification (70.3％),significantly higher than that in the ER +/PR +/HER-2- group (23.1％,P=0.002)and ER-/PR-/HER-2+ group(10.2％,P＜0.001).Conclusions Different types of breast cancer have different biological characteristics and mammographic features. Analysis of the