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目的探讨乳腺导管原位癌(ductal carcinoma in situ,DCIS)的钼靶X线特点,并分析其与病理分级、雌激素与孕激素受体(ER/PR)表达的相关性。资料与方法搜集经手术、病理证实的43例单纯性乳腺DCIS,观察其钼靶X线表现,并与病理分级对照。结果 (1)钼靶表现:43例中单纯钙化10例,结构紊乱伴细小钙化5例,肿块伴钙化9例,单纯结构紊乱7例,单纯肿块8例,非对称性致密4例;钼靶X线评估在乳腺影像-报告和数据系统(BI-RADS)分类中2、3类者共12例,其中结构紊乱及非对称性致密者11例。(2)43例中出现钙化者24例,表现为中间性钙化者13例,高度恶性钙化者11例,中间性钙化出现在非高级别组中6例,高度恶性钙化出现在高级别组中11例,两者间差异具有统计学意义(P=0.016)。(3)钼靶表现与病理分级、ER/PR表达的关系:11例非高级别组中,10例ER/PR阳性,6例钼靶表现为结构紊乱伴或不伴有细小钙化,2例表现为非对称性致密;32例高级别组中,14例ER/PR阳性,6例钼靶表现为结构紊乱,2例表现为非对称性致密,ER/PR表达与病理学分级间差异有统计学意义(P=0.018),钼靶表现与病理分级之间差异有统计学意义(P=0.018)。结论 DCIS的钼靶X线表现具有一定特征性,但对结构紊乱伴或不伴有细小钙化及非对称性致密易低估。钼靶X线表现与基于分子生物改变为基础的病理分级密切相关,对患者的预后、临床治疗方法的选择具有参考价值。
Objective To investigate the mammographic characteristics of ductal carcinoma in situ (DCIS) and to analyze its correlation with pathological grade, estrogen and progesterone receptor (ER / PR) expression. Materials and Methods 43 cases of simple breast DCIS confirmed by operation and pathology were collected and observed for mammographic X-ray findings and compared with pathological grade. Results (1) The results of mammography showed that there were 10 simple calcifications in 43 cases, 5 cases of structural calculi with microcalcification, 9 cases of calcification, 7 cases of simple structural disorder, 8 cases of simple mass and 4 cases of asymmetric densification. X-ray assessment in the Breast Imaging - Reporting and Data System (BI-RADS) classification, a total of 12 categories of 12 patients, including structural disorders and asymmetric dense in 11 cases. (2) There were 24 cases of calcification in 43 cases, including 13 cases of intermediate calcification, 11 cases of highly malignant calcification, 6 cases of intermediate calcification in non-high grade group, and high grade malignant calcification in high grade group 11 cases, the difference was statistically significant (P = 0.016). (3) The relationship between mammography and pathological grade, ER / PR expression: In 11 non-high-grade group, 10 cases were positive for ER / PR and 6 cases were structural disorder with or without small calcification. In 32 high-grade group, 14 cases of ER / PR positive, 6 cases of molybdenum target showed structural disorder, 2 cases showed asymmetric dense, ER / PR expression and pathological grading differences Statistical significance (P = 0.018), mammography between the performance and pathological grade difference was statistically significant (P = 0.018). Conclusion DCIS possesses some characteristic features of mammographic X-ray, but it is easy to underestimate the structural disorder with or without small calcification and asymmetric densification. Molybdenum target X-ray manifestations are closely related to the pathological grading based on molecular biological changes, which has reference value for the prognosis of patients and the choice of clinical treatment methods.