CAJ | 학술논문

乳腺钙化灶在乳腺癌的早期诊断、监控复发及判断预后方面有重要意义。目前乳腺钙化形成的机制尚不明确。肿瘤微环境中生理性矿化调节因子的失调，可能是钙化产生的重要原因。传统的诊断方法主要依赖于影像学上钙化灶的形态学特征和分布特点，它们与乳腺癌的病理类型、肿瘤生物学特性有关。与形态学相比，乳腺钙化灶的化学成分可能与肿瘤性质关系更为密切。依照化学成分，乳腺钙化可以分为两型，I型为二水草酸钙，出现在良性病变中；Ⅱ型为羟基磷灰石，见于增生性病变，多为恶性。同时，Ⅱ型钙化中碳酸盐的含量与肿瘤恶性程度相关。虽然数字乳腺断层融合X线摄影等技术的出现优化了钙化灶的影像学诊断方法，但依旧不能提供钙化灶化学成分的信息，也不能准确界定肿瘤的性质。最新的研究利用拉曼光谱可以无创地获取钙化的化学成分信息，用于区分良恶性钙化灶，可能是未来诊断的发展方向。
유선개화조재유선암적조기진단、감공복발급판단예후방면유중요의의。목전유선개화형성적궤제상불명학。종류미배경중생이성광화조절인자적실조，가능시개화산생적중요원인。전통적진단방법주요의뢰우영상학상개화조적형태학특정화분포특점，타문여유선암적병리류형、종류생물학특성유관。여형태학상비，유선개화조적화학성분가능여종류성질관계경위밀절。의조화학성분，유선개화가이분위량형，I형위이수초산개，출현재량성병변중；Ⅱ형위간기린회석，견우증생성병변，다위악성。동시，Ⅱ형개화중탄산염적함량여종류악성정도상관。수연수자유선단층융합X선섭영등기술적출현우화료개화조적영상학진단방법，단의구불능제공개화조화학성분적신식，야불능준학계정종류적성질。최신적연구이용랍만광보가이무창지획취개화적화학성분신식，용우구분량악성개화조，가능시미래진단적발전방향。
Breast calciifcation plays an important role in breast cancer in various areas, such as early-stage diagnosis, recurrence monitoring and prognosis prediction. However, the mechanism of breast calciifcations remains elusive. One proposed mechanism is based on an imbalance between the enhancers and inhibitors of physiological mineralization. Traditionally, the classiifcation of breast calciifcation is based on the assessment of morphology and distribution. These radiology features are closely related to pathology and biological behavior of tumor. However, chemical composition of calciifcations can provide us with more information about tumor status. Calciifcations could be divided into two categories according to chemical composition. Type I (calcium oxalate) is found in benign breast disease, while typeⅡ (hydroxyapatite) is found in proliferative lesions, mostly to be associated with malignancy. Moreover, carbonate concentrations in typeⅡ calciifcations is related to pathology grades. Despite emerging imaging technologies such as digital breast tomosynthesis, they are unable to yield any information on chemical composition of breast calciifcations and thus cannot provide a deifnitive marker for classifying benign and malignant lesions. Recent researches show that using Raman spectroscopy, the chemical information of calcification could be obtained non-invasively and might provide us with a better mode for calciifcation diagnosis in the future.