【摘要】 目的探讨乳腺导管原位癌(DCIS)的超声征象、X线摄影表现及其与ER、PR、HER-2表达之间的关系。方法回顾性分析2010年1月至2014年3月石河子大学第一附属医院49例乳腺导管原位癌患者的临床、病理、超声和X线摄影资料。采用χ2检验分析年龄、超声征象及钼靶X线表现与ER、PR、HER-2表达的关系,采用Fisher确切概率法分析肿块直径与ER、PR、HER-2表达的关系。结果超声声像图表现为肿块型的乳腺导管原位癌中,ER、PR、HER-2阳性率分别为81.25%(26/32)、87.50%(28/32)、68.76%(22/32),而在非肿块型乳腺导管原位癌中,ER、PR、HER-2阳性率分别为8/17、8/17、10/17。肿块型DCIS中ER、PR阳性率明显高于非肿块型(χ2=6.110、7.356,P=0.013、0.007),但两组间HER-2阳性率的差异却无统计学意义(χ2=0.483,P=0.487)。X线摄影表现为钙化型的乳腺导管原位癌中,ER、PR、HER-2阳性率分别为60.61%(20/33)、75.76%(25/33)、75.76%(25/33),非钙化组的乳腺导管原位癌中ER、PR、HER-2阳性率分别为14/16、11/16、7/16。钙化型DCIS中HER-2阳性率明显高于非钙化型(χ2=4.872,P=0.027),但两组间ER、PR阳性率的差异均无统计学意义(χ2=2.512、0.031,P=0.113、0.860)。超声发现钙化的例数占X线摄影发现钙化例数的54.54%(18/33)。结论超声声像表现为肿块的DCIS,其ER、PR高表达;X线摄影表现为钙化的DCIS,其HER-2也高表达。以上特征可在一定程度上指导临床制定个体化诊治方案。更多还原

【Abstract】 Objective To explore the relationship of ultrasonographic and mammographic characteristics with expressions of ER,PR and HER-2 in breast ductal carcinoma in situ( DCIS). Methods The clinical,pathological,ultrasonographic and mammographic data of 49 cases of DCIS in the First Affiliated Hospital of Shihezi University from January 2010 to March 2014 were retrospectively analyzed. χ2test was used to detect the correlation of age,ultrasonographic and mammographic characteristics with the expressions of ER,PR and HER-2. Fisher’s exact test was used to detect the correlation between the diameter of mass and the expression of ER,PR and HER-2. Results The positive rate of ER,PR and HER-2 was 81. 25%( 26 /32),87. 50%( 28 /32) and 68. 76%( 22 /32) in DCIS group with mass ultrasonographic characteristics,8 /17,8 /17 and 10 /17 in DCIS group with non-mass ultrasonographic characteristics. The positive rates of ER and PR in mass group were significantly higher than those in non-mass group( χ2= 6. 110,7. 356; P = 0. 013,0. 007),while HER-2 positive rate showed no significant difference between two groups( χ2= 0. 483,P = 0. 487). The positive rate of ER,PR and HER-2 was 60. 61%( 20 /33),75. 76%( 25 /33) and 75. 76%( 25 /33) in mammographic calcification group of DCIS,14 /16,11 /16 and 7 /16 in mammographic non-calcification group.HER-2 positive rate in mammographic calcification group was significantly higher than that in mammographic non-calcification group( χ2= 4. 872,P = 0. 027),while there were no statistical differences in positive rates of ER and PR between two groups( χ2= 2. 512,0. 031; P = 0. 113,0. 860). There were 18 patients with calcification found by ultrasound, accounting for 54. 54% of the patients with calcification found by mammography( 33 cases). Conclusion ER and PR are highly expressed in DCIS with mass ultrasonographic characteristics,and HER-2 is highly expressed in DCIS with mammographic calcification characteristics,which may provide guidance for the individualized diagnosis and treatment in clinic.更多还原