乳腺X线摄影中乳腺癌直接征象与转移的关系

目的：分析浸润性导管癌的乳腺 X 线摄影中直接征象特征,研究其与淋巴结转移之间的关系。方法根据217例乳腺浸润性导管癌在乳腺 X 线中显示病灶的直接征象情况分为4组：有肿块有钙化组、有肿块无钙化组、无肿块有钙化组及无肿块无钙化组,分别研究肿块或钙化大小、形态等特征与转移之间的关系。结果有肿块有钙化组的乳腺癌转移率为56.31%,为4组中最高(P =0.004)；出现皮肤乳头凹陷率为38.83%,为4组中最多(P =0.043)；有肿块组比无肿块组出现转移率较高(分别为46.27%和18.75%,P =0.033)；肿块有无分叶或毛刺表现在转移率比较中无差异(46.70% vs 25.00%和43.37% vs 52.00%,P =0.389和 P =0.348)；有钙化组比无钙化组出现转移的概率大(53.57% vs 34.29%,P =0.001)；而钙化灶仅表现为点状及点状加蠕虫状时转移率无差异(51.19% vs 60.71%,P =0.382)；在出现肿块的201例乳腺癌病例中,无论是否出现转移,肿块体积大小无差异分别为(81.04±119.45)mm3 vs (70.06±208.30)mm3,P =0.654]；肿块有分叶者比无分叶者体积大(76.50±174.13)mm3 vs (8.39±10.27)mm3,P =0.000],而有毛刺的肿块体积则较小(52.10±85.90)mm3 vs (144.75±304.13)mm3,P =0.038],肿块是否伴有钙化出现与肿块大小无明显差异(80.39±126.62)mm3 vs (69.63±209.12)mm3,P =0.660],但是仅出现点状钙化的肿块比同时出现点状加蠕虫状钙化的肿块体积大(92.79±137.21)mm3 vs (41.71±94.58)mm3,P =0.041]。结论乳腺 X 线摄影中肿块与钙化在判断浸润性导管癌的恶性程度方面有一定的价值。

The relationship between the direct signs of breast cancer and the metastasis in the mammography

Objective To analyze the relationship between the direct signs of invasive ductal carcinoma and the metastasis in the mammography.Methods 21 7 patients with invasive ductal carcinoma in the mammography were divided into four groups:mass with calcification group,mass without calcification group,calcification without mass group and the group without both mass and calcification. The correlation between metastasis and the size and shape of mass or calcification was studied.Results The rate of metastasis in the group with mass and calcification was 56.31%,and the percentage of the skin and nipple depressed in this group was 38.83%,both of whom were highest (P =0.004 and P =0.043)among four groups.The rate of metastasis in mass group was higher than that in the group without mass (46.27% vs 18.75%,P =0.033).Meanwhile,the edge burr and lobulation of the mass didn’t exert remarkable influence on the rate of metastasis (46.70% vs 25.00% and 43.37% vs 52.00%,P =0.389 and P =0.348).The probability of me-tastasis in the calcification group was higher than that in noncalcification group (53.57% vs 34.29%,P =0.001 ).However,in the calcification group,the different shapes of calcification did not result in significant difference in the rate of metastasis (51.19% vs 60.71%, P =0.382).In the 201 patients with breast cancer mass,the size of mass did not correlate with metastasis (81.04±1 1 9.45)mm3 vs (70.06±208.30)mm3 ,P =0.654].The masses with lobulation were bigger than others (7 6 .5 0 ± 1 7 4 .1 3 )mm 3 vs (8 .3 9 ± 1 0 .2 7 )mm 3 ,P =0.000],while the masses with edge burr were smaller than those with smooth edges (52.10 ±85.90)mm3 vs (144.75±304.13)mm3 ,P =0.038].There was no significant correlation between the size of mass and the calcification (80.39 ± 126.62)mm3 vs (69.63±209.12)mm3 ,P =0.660].However,the masses with point calcification were larger than those with both point and worm calcifications (92.79±137.21)mm3 vs (41.71±94.58)mm3 ,P =0.041].Conclusion The mass and calcification in the mammography are valuable for judging the malignant degree of invasive ductal carcinoma.