乳腺浸润性导管癌的X光影像与分子分型及其组织学分级的相关性研究

doi:10.11904/j.issn.1002-3070.2021.02.009

实用肿瘤学杂志 ›› 2021, Vol. 35 ›› Issue (2): 148-153.doi: 10.11904/j.issn.1002-3070.2021.02.009

乳腺浸润性导管癌的X光影像与分子分型及其组织学分级的相关性研究

刘克^1,2,3, 王胜林³

1.承德医学院研究生学院(承德 067000);
2.保定市第一中心医院超声科;
3.承德医学院附属医院放射科

收稿日期:2020-10-14 修回日期:2020-12-14 出版日期:2021-04-28 发布日期:2021-04-27
通讯作者: 王胜林,E-mail:shl_w2005@163.com
作者简介:刘克,男,(1985-),硕士,主治医师,从事乳腺疾病的影像学研究。

Research on the correlation between X-ray imaging and molecular types and histological grade of breast invasive ductal carcinoma

LIU Ke^1,2,3, WANG Shenglin³

1. Graduate School of Chengde Medical university,Chengde 067000,China;
2. Department of Ultrasound,The First Central Hospital of Baoding City;
3. Department of Radiology,The Affiliated Hospital of Chengde Medical University

Received:2020-10-14 Revised:2020-12-14 Online:2021-04-28 Published:2021-04-27

摘要/Abstract

摘要： 目的探索不同分子亚型乳腺浸润性导管癌病灶X光影像的差异,以及与组织学分级的相关性。方法收集因乳腺肿物住院,且均进行术前乳腺X光摄片,并最终通过病理检查确诊为乳腺浸润性导管癌的患者完整诊疗资料。回顾性分析术前X光影像及术后病理学资料,参照2019版中国临床肿瘤学会乳腺癌诊疗指南(CSCO BC指南)推荐方法进行分子分型,比较不同分子亚型组间的X光影像差异并探讨病灶X光征像与组织学分级之间的联系。结果五组分子亚型的X光影像在腺体分型、肿块类型及肿块边缘特征等方面存在统计学差异(P＜0.05)。其中三阴型的腺体分型多为散在纤维腺体型(50.0%,18/36);对比其余分子亚型,三阴型多表现为单纯肿块(83.3%,30/36)且肿块边缘光整(52.8%,19/36);不同病理组织学分级病灶的X光影像在腺体分型、肿块类型及肿块边缘特征等方面存在统计学差异(P＜0.05)。对比中高分化组,低分化组的腺体分型多为散在纤维腺体型(37.3%,19/51),X线影像多表现为单纯肿块型(52.9%,27/51)且肿块边缘多光整(31.4%,16/51)。多因素Logistic回归分析显示,肿块边缘特征是X光影像辨别低分化组浸润性导管癌病灶的独立危险因素(P＜0.05);乳腺浸润性导管癌的分子分型与组织学分级具有相关性(V=0.482,P＜0.001),其中三阴型低分化组占比(63.9%,23/69)及Luminal A的中高分化组占比(97.2%,72/74)均显著高于其余亚组(P＜0.001)。结论乳腺浸润性导管癌的X线影像可以一定程度上辨别分子分型及病理组织学分级,能够为乳腺癌患者个性化治疗方案的选择及治疗效果的提前预测提供影像学依据。

关键词: 乳腺浸润性导管癌, 乳腺X光影像, 分子分型, 组织学分级

Abstract: Objective The aim of this study was to explore the different mammographic features of breast invasive ductal carcinoma with different molecular subtypes and the correlation with histological grade. Methods The complete diagnosis and treatment data of patients hospitalized with breast tumors during the period and all received preoperative mammography to be finally diagnosed with invasive ductal carcinoma of the breast through pathological examination were collected and sorted out.Referring to the 2019 Chinese Society for Clinical Oncology Breast Cancer Diagnosis and Treatment Guidelines(CSCO BC Guidelines)recommend methods for molecular typing,the preoperative X-ray images and postoperative pathological data were retrospectively analyzed to compare the differences in X-ray images between different molecular subtype groups and the relationship with histopathological grade. Results The five groups of molecular subtypes showed significant differences in X-ray images in terms of gland type,malignant calcification,and mass characteristics(P＜0.05).Among them,the three-negative gland type was mostly scattered and fibrous(52.8%,19/36),and the proportion of malignant calcification(13.9%,5/36),blurred edges(16.3%,7/36)and astral signs(9.3%,4/36)on the edges of the tumor was significantly reduced.The five molecular subtypes had significant differences in histological grading(P＜0.01),of which the proportion of three-negative poorly differentiated group(63.9%,23/69)and the proportion of Luminal A's moderately differentiated group(97.2%,72/74)were significantly higher than the other subgroups.Multivariate logistic regression showed that X-ray images with clear tumor edges were a risk factor for the poorly differentiated group(P＜0.05). Conclusion The X-ray images of invasive ductal carcinoma of the breast can help predict its molecular classification and histological grade to a certain extent,and can provide some help for personalized diagnosis and treatment and prognostic analysis of breast cancer patients.

Key words: Breast invasive ductal carcinoma;Mammography;Molecular typing;Histological grading

中图分类号:

R737.9

刘克, 王胜林. 乳腺浸润性导管癌的X光影像与分子分型及其组织学分级的相关性研究[J]. 实用肿瘤学杂志, 2021, 35(2): 148-153.

LIU Ke, WANG Shenglin. Research on the correlation between X-ray imaging and molecular types and histological grade of breast invasive ductal carcinoma[J]. Journal of Practical Oncology, 2021, 35(2): 148-153.

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乳腺浸润性导管癌的X光影像与分子分型及其组织学分级的相关性研究

Research on the correlation between X-ray imaging and molecular types and histological grade of breast invasive ductal carcinoma

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