Ultrasound, molybdenum target mammography and clinicopathological characteristics of ductal carcinoma in situ of the breast underestimated by preoperative core needle biopsy
ZHOU Han-xiao, WANG Hong-qiao
Department of Ultrasound, Affiliated Hospital of Qingdao University, Qingdao Shandong 266000, China
摘要目的：探究术前粗针活检诊断为导管内原位癌（Ductal carcinoma in situ，DCIS）的病灶中，术后病理发现伴有浸润癌的病灶的超声、钼靶及临床病理特征，以便于术前评估DCIS伴有浸润成分的可能性，帮助更好的制定DCIS的手术及治疗方案。方法：对术前粗针活检诊断为DCIS并接受手术切除的78个病灶进行回顾性研究，根据术后病理结果分成两组（DCIS组、DCIS-Ⅰ组），进行描述性统计及回归分析。结果：术后病灶中45（57.6%）个证实为DCIS，33（37.9%）个发现伴有浸润癌成分，Ki-67高表达（OR=2.870，95%CI=1.065~7.730）、EGFR阳性（OR=4.833，95%CI=1.083~21.561）、超声可见微钙化（OR=4.533，95%CI=1.627~12.633）都是与DCIS术前被低估相关的因素，其中超声可见微钙化（OR=4.746，95%CI=1.263~17.828）最具有相关性。结论：对于术前穿刺活检诊断为DCIS的病灶，如果其存在有 Ki-67高表达、EGFR阳性、超声可见微钙化的特征，应警惕其有较高可能伴有浸润癌成分。
Abstract：Objective: To explore the ultrasonographic, molybdenum target mammography and clinicopathological features of the lesions with invasive carcinoma which were diagnosed as ductal carcinoma in situ(DCIS) by preoperative core needle biopsy, so as to evaluate the possibility of invasive components in DCIS before operation, and to help better formulate the surgical and therapeutic plan of DCIS. Methods: Seventy-eight lesions diagnosed as DCIS by preoperative core needle biopsy and resected by surgery were retrospectively analyzed. According to the pathological results after operation, they were divided into two groups(DCIS group and DCIS-Ⅰ group) for descriptive statistics and regression analysis. Results: Of the 78 lesions, 45(57.6%) were confirmed as DCIS and 33(37.9%) were found to have invasive components. Ki-67 overexpression(OR=2.870, 95%CI=1.065~7.730), EGFR positive(OR=4.833, 95%CI=1.083~21.561), ultrasound-detected microcalcification (OR=4.533, 95%CI=1.627~12.633) were correlated with predicting invasive components in DCIS, ultrasound-detected microcalcification(OR=4.746, 95%CI=1.263~17.828) was the most relevant factor in predicting invasive components in DCIS. Conclusion: For the lesions diagnosed as DCIS by preoperative core needle biopsy, if there are high expression of Ki-67, positive EGFR and microcalcification in ultrasound, we should be alert to the high risk of invasive components in DCIS.
周涵霄，王宏桥. 术前粗针活检低估的乳腺导管内原位癌的超声、钼靶及临床病理特征分析[J]. 中国临床医学影像杂志, 2019, 30(4): 257-260.
ZHOU Han-xiao, WANG Hong-qiao. Ultrasound, molybdenum target mammography and clinicopathological characteristics of ductal carcinoma in situ of the breast underestimated by preoperative core needle biopsy. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(4): 257-260.
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