CAJ | 학술논문

目的：探讨乳腺浸润性导管癌M RI增强形态类型与年龄的相关性及其病理基础。方法收集经病理学证实的乳腺浸润性导管癌97例，均进行了 MRI 动态增强检查。2名放射科医生独立阅片确定肿瘤 MRI 增强后形态类型（肿块／非肿块样强化）及大小。2名病理科医生确定浸润性导管癌成分的组织学分级及肿瘤内是否含有导管内原位癌（duc‐tal carcinoma in situ ，DCIS）。分析 MRI 增强形态类型与年龄段的相关性，青年与中、老年 MRI 增强形态类型是否有显著差异，肿块与非肿块型乳腺癌病变大小、浸润性导管癌成份组织学分级及 DCIS 存在与否的差异性。结果 MRI 增强形态类型与年龄显著相关（ P ＝0．000）；40岁（含）以下青年中的非肿块型乳腺癌比40岁以上中老年的明显增多（ P ＝0.000）。非肿块型乳腺癌大小大于肿块型（ P ＝0．022）。非肿块型乳腺癌中病理含 DCIS 者明显多于肿块型乳腺癌（ P＝0．000），且前者浸润性导管癌成分的组织学分级明显低于后者（ P ＝0．006）。结论非肿块型乳腺癌更易发生于青年，肿块型乳腺癌更易发生于中老年。非肿块型乳腺癌与存在 DCIS 显著相关，但浸润性导管癌成分组织学分级相对较低，其恶性程度未必差于肿块型乳腺癌。
목적：탐토유선침윤성도관암M RI증강형태류형여년령적상관성급기병리기출。방법수집경병이학증실적유선침윤성도관암97례，균진행료 MRI 동태증강검사。2명방사과의생독립열편학정종류 MRI 증강후형태류형（종괴／비종괴양강화）급대소。2명병이과의생학정침윤성도관암성분적조직학분급급종류내시부함유도관내원위암（duc‐tal carcinoma in situ ，DCIS）。분석 MRI 증강형태류형여년령단적상관성，청년여중、노년 MRI 증강형태류형시부유현저차이，종괴여비종괴형유선암병변대소、침윤성도관암성빈조직학분급급 DCIS 존재여부적차이성。결과 MRI 증강형태류형여년령현저상관（ P ＝0．000）；40세（함）이하청년중적비종괴형유선암비40세이상중노년적명현증다（ P ＝0.000）。비종괴형유선암대소대우종괴형（ P ＝0．022）。비종괴형유선암중병리함 DCIS 자명현다우종괴형유선암（ P＝0．000），차전자침윤성도관암성분적조직학분급명현저우후자（ P ＝0．006）。결론비종괴형유선암경역발생우청년，종괴형유선암경역발생우중노년。비종괴형유선암여존재 DCIS 현저상관，단침윤성도관암성분조직학분급상대교저，기악성정도미필차우종괴형유선암。
Objective To investigate the age preference of mass and non‐mass type invasive ductal breast cancer and to compare their pathologic features .Methods Ninety‐seven consecutive cases of pathologic‐proven invasive ductal breast cancers were collected .All the patients underwent MRI dynamic enhancement examination before surgery or biopsy .Two radiologists independently assessed the images of each lesion for the morphologic enhancement type (mass enhancement or non‐mass‐like enhancement) and measured lesion size in consensus .Two pathologists independently evaluated the presence or absence of ductal carcinoma in situ (DCIS) and histological grade of invasive component .The correlation between MRI morphologic enhancement type and age was analyzed by Spearman rank correlation .The morphologic enhancement type between the young (less than 40 y/o) and the older counterpart (older than 40 y/o) were compared by Fisher exact test . The lesion size ,the difference of histological grades of invasive component and status of DCIS between mass and non‐mass type were compared .Results The enhancement type was correlated with age ( P = 0 .000) .The young (below 40 y/o) had more non‐mass type than the older counterpart (beyond 40 y/o) ( P = 0 .000) .The lesion size of non‐mass type was larger than mass type ( P = 0 .022) .The non‐mass type was significantly related to the presence of DCIS and low histolog‐ical grade of invasive components ,compared with mass type ,with P = 0 .000 ,0 .006 ,respectively .Conclusion Non‐mass‐type breast cancer prefers to occur in the young ,while the older are more vulnerable to mass type .Compared with mass type ,non‐mass type breast cancer often has larger tumor size ,but may not necessarily have worse malignant behavior due to strongly related to presence of DCIS and low histological grade of invasive components .