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山东大学学报（医学版） ›› 2017, Vol. 55 ›› Issue (11): 54-58.doi: 10.6040/j.issn.1671-7554.0.2016.1274

• 临床医学 • 上一篇    下一篇

非肿块型乳腺单纯性导管内癌声像图特征及病理学相关分析

张佩佩1,2,刘德泉3,王蓓2,赫淑倩4,李菲1,2,丁红宇2,孙洪军2   

  1. 1. 山东大学临床医学院, 山东 济南 250012;2. 山东大学附属千佛山医院超声诊疗科, 山东 济南 250014;3. 泰山医学院, 山东 泰安 271000;4. 山东大学附属千佛山医院病理科, 山东 济南 250014
  • 收稿日期:2016-10-09 出版日期:2017-11-10 发布日期:2017-11-10
  • 通讯作者: 孙洪军. E-mail:qysunhongjun@163.com丁红宇. E-mail:hongyuding@sina.com E-mail:qysunhongjun@163.com

Sonographic findings and pathological features of non-mass pure ductal carcinoma in situ

ZHANG Peipei1,2, LIU Dequan3, WANG Bei2, HE Shuqian4, LI Fei1,2, DING Hongyu2, SUN Hongjun2   

  1. 1. School of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Department of Ultrasound, Qianfoshan Hospital Affiliated to Shandong University, Jinan 250014, Shandong, China;
    3. Taishan Medical University, Taian 271000, Shandong, China;
    4. Department of Pathology, Qianfoshan Hospital Affiliated to Shandong University, Jinan 250014, Shandong, China
  • Received:2016-10-09 Online:2017-11-10 Published:2017-11-10

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摘要： 目的 探讨非肿块型乳腺单纯性导管内癌声像图特征,并行病理学相关分析。 方法 收集2014年9月至2016年6月32例非肿块型乳腺单纯性导管内癌的声像图,分析其病灶的边缘、内部回声、局部腺体增生、微钙化及病灶内血流阻力指数(RI)等,同时行病理学分析。 结果 32例非肿块型乳腺单纯性导管内癌中常表现为乳腺腺体局部增生明显,内回声强弱不等,如“豹纹征”或“斑马纹征”,彩色多普勒可见病灶内较丰富的血流信号,RI>0.7,偶可见单纯乳导管扩张,病灶内偶可见微钙化灶。非肿块型乳腺单纯性导管内癌中高级别导管内癌占多数。 结论 非肿块型乳腺单纯性导管内癌常表现为乳腺腺体局部增生明显,内回声强弱不等;病理学类型常为高级别导管内癌;彩色多普勒及RI的测量可以辅助诊断非肿块型乳腺单纯性导管内癌。

关键词: 非肿块型, 声像图特征, 乳腺单纯性导管内癌, 病理学

Abstract: Objective To explore the characteristic sonographic findings and pathological features of non-mass pure ductal carcinoma in situ(DCIS). Methods The sonographic findings of 32 cases of non-mass pure DCIS treated during Sep. 2014 and Jun. 2016 were retrospectively analyzed. The edge of the lesion, internal echo, local gland hyperplasia, microcalcification and blood flow resistance index(RI)were reviewed. Results The major manifestations included focal gland hyperplasia and uneven internal echo intensity. Color Doppler showed rich blood flow around the lesions, with RI>0.7. Mammoductal ectasis and microcalcifications could be observed. Most DCIS were of high grade. Conclusion Non-mass pure DCIS manifests with focal gland hyperplasia disorders and uneven internal echo intensity. Most DCISs are of high pathological grade. Color Doppler and detection of RI can be helpful in the diagnosis of DCIS.

Key words: Breast pure ductal carcinoma in situ, Sonographic findings, Non-mass, Pathology

中图分类号: 

  • R445.1
[1] 范凤景, 张广英, 曹淑娟, 等. 声触诊组织量化技术在乳腺肿块定性诊断中的价值[J]. 山东大学学报(医学版), 2016, 54(9): 48-52. FAN Fengjing, ZHANG Guangying, CAO Shujuan, et al. Diagnostic value of virtual touch tissue quantification in the differential diagnosis of breast tumors[J]. Journal of Shandong University(Health Science), 2016, 54(9): 48-52.
[2] 王知力, 唐杰, 李俊来, 等. 乳腺非肿块型病变的超声诊断[J]. 中国医学影像学杂志, 2013, 21(1): 13-15, 19. WANG Zhili, TANG Jie, LI Junlai, et al. Ultrasound diagnosis of non-mass-like breast lesions[J]. Chinese Journal of Medical Imaging, 2013, 21(1): 13-15, 19.
[3] Boonjunwetwatmd D, Chyutipraiwan U, Sampatanukul P, et al. Sensitivity of mammography and ultrasonography on detecting abnormal findings of ductal carcinoma in situ[J]. J Med Assoc Thai, 2007, 90(3): 539-545.
[4] 贺琰, 王小燕, 凌冰, 等. 乳腺导管内癌的超声图像及造影特征与病理对照分析[J]. 中国超声医学杂志, 2015, 31(6): 494-497. HE Yan, WANG Xiaoyan, LING Bing, et al. Characteristic of ultrasonography and contrast-enhanced ultrasound for the breast ductal carcinoma in situ correlation with pathology [J]. Chinese J Ultrasound Med, 2015, 31(6): 494-497.
[5] 林僖, 林庆光, 李程, 等. 超声检查对乳腺导管内癌的早期诊断价值[J/CD]. 中华医学超声杂志, 2016, 13(4): 297-301. LIN Xi, LIN Qingguang, LI Cheng, et al. The early diagnostic value of ultrasound in ductal carcinoma in situ of breast [J/CD]. Chin J Med Ultrasound(Electronic Edition), 2016, 13(4): 297-301.
[6] Adler DD, Carson PL, Rubin JM. Doppler ultrasound color flow imaging in the study of breast cancer: preliminary findings [J]. Ultrasound Med Biol, 1990, 16(6): 553-559.
[7] 孙琳, 杨顺实, 田青青, 等. 乳腺导管内癌及其微浸润与乳腺浸润性导管癌的超声及病理特征[J]. 中国超声医学杂志, 2015, 31(5): 394-397. SUN Lin, YANG Shunshi, TIAN Qingqing, et al. Ultrasonicand pathological characteristics of breast ductal carcinoma in situ with microinvasion and breast invasive ductal carcinoma [J]. Chinese J Ultrasound Med, 2015, 31(5): 394-397.
[8] Wang LC, Sullivan M, Du H, et al. US appearance of ductal carcinoma in situ [J]. Radiographics, 2013, 33(1): 213-228.
[9] Moon WK, Im JG, Koh YH, et al. US of mammographically detected clustered microcalcifications [J]. Radiology, 2000, 217(3): 849-854.
[10] Yang WT, Tse GM. Sonographic, mammographic, and histopathologic correlation of symptomatic ductal carcinoma in situ [J]. Ajr Am J Roentgenol, 2012, 182(1): 101-110.
[11] Shin HJ, Kim HH, Kim SM, et al. Screening-detected and symptomatic ductal carcinoma in situ: differences in the sonographic and pathologic features [J]. AJR Am J Roentgenol, 2008, 190(2): 516-525.
[12] Lee MH, Ko EY, Han BK, et al. Sonographic findings of pure ductal carcinoma in situ [J]. J Clin Ultrasound, 2013, 41(8): 465-471.
[13] 蒋蓓琦, 贺其志, 章华, 等. 乳腺导管内癌超声声像图特征和临床病理的相关性研究[J]. 现代肿瘤医学, 2010, 18(2): 287-290. JIANG Beiqi, HE Qizhi, ZHANG Hua, et al. An analysis of the correlation between sonography and pathology of ductal carcinoma in situ of the breast [J]. Journal of Modern Oncology, 2010, 18(2):287-290.
[14] 李伟伟,陈牧云,陶玲玲,等.乳腺导管内癌超声诊断价值[J].中国超声医学杂志, 2013, 29(1): 45-48. LI Weiwei, CHEN Muyun, TAO Lingling, et al. Ultrasonographic diagnosis of breast ductal carcinoma in situ[J]. Chinese J Ultrasound Med, 2013, 29(1): 45-48.
[15] Ricci P, Cantisani V, Ballesio L, et al. Benign and malignant breast lesions: efficacy of real time contrast-enhanced ultrasound vs. magnetic resonance imaging [J]. Ultraschall Med, 2007, 28(1): 57-62.
[16] Hashimoto BE, Kramer DJ, Picozzi VJ. High detection rate of breast ductal carcinoma in situ calcifications on mammographically directed high-resolution sonography [J]. J Ultrasound Med, 2001, 20(5): 501-508.
[17] 贺红艳, 张大伟, 韦德湛, 等. 钼靶、超声检出微钙化灶对乳腺癌诊断价值的研究[J]. 中国妇幼保健, 2013, 28(22): 3678-3681. HE Hongyan, ZHANG Dawei, WEI Dezhan, et al. Study on the significance of microcalcification detected by molybdenum target photography and ultrasonography in diagnosis of breast cancer[J]. Maternal and Child Health Care of China, 2013, 28(22): 3678-3681.
[18] 金占强, 徐晓红. 高频彩色多普勒超声诊断乳腺导管原位癌[J]. 中国临床医学影像杂志, 2011, 22(10): 697-700. JIN Zhanqiang, XU Xiaohong. High frequency color Doppler ultrasonography in the diagnosis of ductal carcinoma in situ [J]. Journal of China Clinic Medical Imaging, 2011, 22(10): 697-700.
[19] 袁榕, 李泉水, 粟晖, 等. 乳腺导管内癌的超声图像特征分析[J/CD]. 中华医学超声杂志, 2011, 8(6): 1250-1254. YUAN Rong, LI Quanshui, SU Hui, et al. Ultrasound manifestations of the breast ductal carcinoma in situ[J/CD]. Chin J Med Ultrasound(Electronic), 2011, 8(6): 1250-1254.
[20] Sakorafas GH, Tsiotou AG. Ductal carcinoma in situ(DCIS)of the breast: evolving perspectives [J]. Cancer Treatment Reviews, 2000, 26(2): 103-125.
[21] Hille H, Vetter M, Hackel(¨overo)er BJ. The suitability of high-resolution ultrasound for the detection of DCIS [J]. Ultraschall Med, 2007, 28(3): 307-312.
[22] Badan GM, Roveda D Júnior, Paito S, et al. Ductal carcinoma in situ of the breast: Evaluation of main presentations on magnetic resonance imaging compared with findings on mammogram and histology [J]. Rev Assoc Med Bras(1992), 2016, 62(5): 421-427.
[23] Leong LC, Sim LS, Jaralazaro AR, et al. Ultrasound Breast Elastographic Evaluation of Mass-Forming Ductal Carcinoma-in-situ with Histological Correlation-New Findings for a Toothpaste Sign [J]. Asian Pac J Cancer Prev, 2016, 17(5): 2673-2678.
[24] Brem RF, Fishman M, Rapelyea JA. Detection of ductal carcinoma in situ with mammography, breast specific gamma imaging, and magnetic resonance imaging: a comparative study 1[J]. Acad Radiol, 2007, 14(8): 945-950.
[25] Duffy SW, Dibden A, Michalopoulos D, et al. Screen detection of ductal carcinoma in situ and subsequent incidence of invasive interval breast cancers: a retrospective population-based study [J]. Lancet Oncol, 2015, 17(1): 109-114.
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