【摘要】 目的 分析乳腺实性乳头状癌(SPC)与非特殊型浸润性癌(IBC-NST)在临床及超声表现上的差异，并探究超声表现与免疫组织化学指标的联系。方法 回顾性收集39例经术后病理证实的SPC患者，按1∶2的比例随机抽取同期就诊的78例IBC-NST为对照组。比较2组患者的临床资料和超声表现，采用向前逐步logistic回归分析，筛选SPC的影响因素，采用χ~2检验探究超声表现差异与免疫组织化学的联系。结果 SPC组患者的中位年龄大于IBC-NST组(71.0岁vs 55.0岁，P<0.001),2组间乳头溢液(血)、边界、微钙化、血供特点、后方回声及腋窝淋巴结肿大等的差别均有统计学意义(P<0.05)。年龄大、乳头溢液(血)、富血供、后方回声增强是SPC的危险因素，有微钙化为保护因素。SPC中，Ki-67高表达组边界清楚的比例高于低表达组(P<0.05);IBC-NST中，ER(+)、PR(+)组乏血供的比例高于ER(-)、PR(-)组，HER-2(+)组微钙化发生率高于HER-2(-)组，Ki-67高表达组与低表达组的后方回声表现存在差别(均为P<0.05)。结论 SPC和IBC-NST在临床及超声特征上存在显著差别，且部分超声征象与免疫组织化学指标相关，可为临床诊断与预后评估提供参考。更多还原

【Abstract】 Objective To analyze the differences in clinical and ultrasonic manifestations between solid papillary carcinoma of the breast(SPC) and invasive breast carcinoma of no special type(IBC-NST), and to explore the association between ultrasonographic manifestations and immunohistochemical indexes. Methods Thirty-nine patients with SPC confirmed by postoperative pathology were retrospectively collected, and 78 cases of IBC-NST attending the same clinic at the same time were randomly selected as the control group at a ratio of 1∶2. The clinical and ultrasonographic manifestations of the two groups were compared. Forward stepwise logistic regression analysis was conducted to screen the influencing factors of SPC, and the chi-square test was used to explore the association between ultrasonographic manifestations and immunohistochemistry. Results The median age of patients in the SPC group was significantly higher than that in the IBC-NST group(71.0 years vs 55.0 years, P<0.001). There are statistically significant differences between the two groups in terms of nipple discharge, margin, microcalcification, blood supply characteristics, posterior echo, and axillary lymph node enlargement(all P<0.05). Advanced age, bloody nipple discharge, rich blood supply, and enhanced posterior echo were risk factors for SPC, while the presence of microcalcifications was a protective factor. In the SPC group, the proportion of well-defined boundaries in the Ki-67 high-expression group was higher than that in the low-expression group(P<0.05). In the IBC-NST group, the proportion of poor blood supply in the ER positive and PR positive groups was higher than that in the negative groups. The incidence of microcalcification in the HER-2 positive group was higher than that in the negative group; and there are differences in the posterior echo manifestations between the Ki-67 high-expression group and the low-expression group(all P<0.05). Conclusion SPC and IBC-NST exhibit significant differences in clinical and ultrasonographic characteristics, and some ultrasonographic signs are correlated with immunohistochemical indexes. These findings can provide references for clinical diagnosis and prognostic evaluation.更多还原