乳腺导管原位癌X线表现与病理及年龄对照研究

目的探讨乳腺导管原位癌的X线表现及其与病理分级、患病年龄的相关性。方法经手术、病理证实的94例乳腺导管原位癌患者，观察其X线表现中钙化形态及软组织异常（分类包括肿块、不对称致密、结构扭曲）与病理分级、患病年龄的相关性。结果（1）乳腺导管原位癌的X线摄影表现为钙化者占80．4％。低、中级别中不定型模糊钙化和粗糙不均质钙化占45．8％，高级别中细小多形性钙化和线样分支状钙化占71．1％（P〈O．05）。线段样分布占53．6％，簇状分布占33．3％，区域分布占13．1％。本研究中有63．8％的导管原位癌患者每平方厘米钙化数目超过20枚。（2）肿块、局灶性不对称致密、结构扭曲（伴或不伴钙化）在乳腺导管原位癌的X线摄影中分别占39．1％、21．7％、3．2％。其中，病理为高级别者占64．4％，中、低级别分别占18．6％、17．0％。（3）50岁以前钙化出现的几率是50以岁后的1.3倍（P〈0．05），单纯钙化容易出现在40-50岁（12．0％）；50岁以后出现软组织异常的比例是50岁以前人群的1．4倍（P〈0．05）。结论乳腺导管原位癌常见的X线摄影表现为单纯钙化、钙化伴肿块、局灶性不对称致密和结构扭曲，与病理分级和年龄有一定相关性，在一定程度上可为临床诊治提供参考。

Mammographic features of ductal carcinoma in situ with pathology and age correlation

Objective To investigate the mammographic features of ductal carcinoma-in-situ （DCIS） of the breast in correlation with pathologic findings and age of the patient. Methods The mammograms of 94 patients with pathologically confirmed DCIS were reviewed. Mammographie findings of calcification, mass, asymmetric density, and architectural distortion were compared with histological grading of the tumor and patients＇ age. Results Microcaleifications were detected on 80.4% of the patients. The low and intermediate tumor grades were associated with amorphous and coarse heterogeneous calcifications （45.8%） whereas high tumor grade was associated with fine pleomorphic, linear or linear branching calcifications （71.1%）. Distribution of the calcifications was segmental or linear （53.6%）, clustered （33.3%）, or regional （13.1%）. Mass （39.1%）, asymmetrical density （21.7%）, architectural distortion （3.2%） with or without calcifications were seen in 64.4%, of the high pathological grade, 18.6% of the intermediate grade, and 17.0% of the low grade DCIS. Calcification before the age of 50 years was 1.3 times more frequent than patients over 50 years of age. Patients between 40 and 50 years of age were more likely to present with only calcifications （12.0%）. Presentation of a mass, asymmetrical density, or architectural distortion was 1.4 times higher in patients over the age of 50 years. Conclusion Mammographic features of DCIS including calcification, mass, asymmetrical density and architectural distortion are closely correlated with the pathological grade and patients＇ age.