乳腺浸润性导管癌的超声征象及与患者临床特征的关系.pdf

癌症进展2023 年 4 月第 21 卷第 8 期ONCOLOGY PROGRESS,Apr 2023 V ol.21,No.8*论著*乳腺浸润性导管癌的超声征象及与患者临床特征的关系乳腺浸润性导管癌的超声征象及与患者临床特征的关系徐鑫利，李彦婷，强军涛，折文利#铜川市人民医院超声医学科，陕西 铜川 7270000摘要摘要：目的目的探讨乳腺浸润性导管癌（IDC）的超声征象及与患者临床特征的关系。方法方法选取88例IDC患者和64例乳腺良性病变患者，所有患者均进行超声检查。分析超声检查对IDC的诊断价值，比较IDC与乳腺良性病变患者的超声征象，比较不同分化程度IDC患者的超声征象。结果结果超声检查诊断IDC的结果与病理结果的一致性良好（Kappa=0.581）。IDC患者中形态不规则、有毛刺征、无微小钙化、血流分级为级、超声弹性成像评分3分的比例均明显高于乳腺良性病变患者，差异均有统计学意义（P0.01）。低分化IDC患者肿瘤直径2 cm、形态不规则、血流分级为级、超声弹性成像评分3分的比例均明显高于中高分化患者，差异均有统计学意义（P0.01）。结论结论IDC患者的超声征象与其临床特征密切相关，且对肿瘤分化程度有提示作用，可为患者的术前诊断和治疗提供参考。关键词关键词：浸润性导管癌；超声征象；临床特征中图分类号中图分类号：R R737737.9 9文献标志码文献标志码：AdoiAdoi：10.11877/j.issn.1672-1535.2023.21.08.25Ultrasonographic features of breast invasive ductal carcinoma and thierUltrasonographic features of breast invasive ductal carcinoma and thierrelationship with clinical characteristics of patientsrelationship with clinical characteristics of patientsXU Xinli,LI Yanting,QIANG Juntao,SHE Wenli#Department of Ultrasound Medicine,Tongchuan People s Hospital,Tongchuan 727000,Shaanxi,ChinaAbstract:ObjectiveAbstract:ObjectiveTo analyze the ultrasonographic features of breast invasive ductal carcinoma(IDC)and thier re-lationship with clinical characteristics of patients.MethodMethodA total of 88 IDC patients and 64 patients with benign breastlesions were selected,and all patients underwent ultrasonography examination.The diagnostic value of ultrasonographyfor IDC was analyzed,the ultrasonographic features of patients with IDC and benign breast lesions were compared,andthe ultrasonographic features in IDC patients with different degrees of differentiation were compared.ResultResultThere wasgood consistency between ultrasonographic diagnosis of IDC and pathological results(Kappa=0.581).The proportion ofIDC patients with irregular shape,spiculation,no microcalcification,grade II-III blood flow,and ultrasound elastographyscore3 points were significantly higher than those of patients with benign breast lesions(P2 cm,irregular shape,grade II-III blood flow,and ultrasound elas-tography score3 points were significantly higher than those of moderately-highly differentiated patients(P2形态规则不规则毛刺征有无微小钙化有无后方回声衰减有无血流分级0超声弹性成像评分33乳腺良性病变n=64，n（%）38（59.38）26（40.62）45（70.31）19（29.69）25（39.06）39（60.94）53（82.81）11（17.19）31（48.44）33（51.56）46（71.88）18（28.12）43（67.19）21（32.81）IDCn=88，n（%）41（46.59）47（53.41）36（40.91）52（59.09）54（61.36）34（38.64）15（17.05）73（82.95）39（44.32）49（55.68）37（42.05）51（57.95）33（37.50）55（62.50）2值2.42612.8697.38264.8230.25313.30013.062P值0.1190.010.010.010.6140.012形态规则不规则毛刺征有无微小钙化有无后方回声衰减有无血流分级0超声弹性成像评分33低分化n=31，n（%）7（22.58）24（77.42）3（9.68）28（90.32）16（51.61）15（48.39）6（19.35）25（80.65）17（54.84）14（45.16）2（6.45）29（93.55）1（3.23）30（96.77）中高分化n=57，n（%）34（59.65）23（40.35）33（57.89）24（42.11）38（66.67）19（33.33）9（15.79）48（84.21）22（38.60）35（61.40）35（61.40）22（38.60）32（56.14）25（43.86）2值11.08819.3111.9190.1802.14624.88323.987P值0.010.010.1650.6700.1420.013分；C.血流信号分级为级910癌症进展2023年4月第21卷第8期参参 考考 文文献献1 杨燕峰,董雪伟.阿帕替尼治疗中晚期胃癌的临床疗效及预后影响因素J.实用癌症杂志,2017,32(8):1318-1320.2 Hirahara T,Arigami T,Yanagita S,et al.Combined neutro-phil-lymphocyte ratio and platelet-lymphocyte ratio pre-dicts chemotherapy response and prognosis in patients withadvanced gastric cancerJ.BMC Cancer,2019,19(1):672.3 杨宁娟,殷常春,潘守杰,等.阿帕替尼联合替吉奥对老年晚期胃癌的疗效J.中国临床研究,2019,32(2):162-165.4 Gonzlez-Domingo M,Ulloa C,Olivares J,et al.Adjuvantradiochemotherapy in locally advanced gastric cancer:fromevidence to daily clinical practice in a single institutionJ.Ecancermedicalscience,2020,14:1137.5 果林.阿帕替尼治疗恶性肿瘤疗效及安全性分析D.天津:天津医科大学,2020.6 Kobayashi D,Kodera Y,Fujiwara M,et al.Assessment ofquality of life after gastrectomy using EORTC QLQ-C30and STO22J.World J Surg,2011,35(2):357-364.7 杨尊敬,杜先玲,杜先艳.阿帕替尼联合放疗治疗晚期胃癌的临床疗效及安全性分析J.实用癌症杂志,2019,34(1):122-124.8 吴莹莹,周江云.阿帕替尼联合调强放疗治疗中晚期非小细胞肺癌的疗效分析J.中国医师杂志,2020,22(2):289-292.9 Kim SM,An JY,Byeon SJ,et al.Prognostic value of mis-match repair deficiency in patients with advanced gastriccancer,treated by surgery and adjuvant 5-fluorouracil andleucovorin chemoradiotherapyJ.Eur J Surg Oncol,2020,46(1):189-194.10 潘妍,施育鹏.阿帕替尼联合化疗对于晚期胃癌患者生存周期及血清sIL-2R、VEGF水平的影响J.中国中西医结合消化杂志,2019,27(2):111-115.11 Ustaalioglu B,Bilici A,Tilki M,et al.Capecitabine-cispla-tin versus 5-fluorouracil/leucovorin in combination withradiotherapy for adjuvant therapy of lymph node positivelocally advanced gastric cancerJ.J Cancer Res Ther,2018,14(Supplement):S736-S741.12 周楠.甲磺酸阿帕替尼联合化疗治疗晚期胃癌合并顽固性癌性腹水的临床疗效研究J.重庆医学,2020,49(S02):27-78.13 徐洋,肖华,姜山山,等.阿帕替尼联合放化疗对中晚期宫颈癌患者临床治疗的影响J.中华老年医学杂志,2021,40(9):1165-1168.14 黄毅超,刘云军,何宛谦,等.阿帕替尼与替吉奥联合治疗晚期胃癌疗效分析及对相关细胞因子的影响J.中国中西医结合消化杂志,2018,26(3):252-255.15 刘跃辉,郑春红,李倩,等.二甲双胍联合阿帕替尼治疗中晚期胃癌患者的疗效及对肠道菌群的影响J.国际消化病杂志,2020,40(1):36-40.16 高金平,韩涛,朴瑛,等.阿帕替尼联合替吉奥治疗老年或瘦弱患者晚期胃癌临床研究J.临床军医杂志,2017,45(1):9-12.17 牛东升,孙丽敏.放疗联合阿帕替尼、多西他赛治疗晚期肺癌的临床疗效研究J.实用癌症杂志,2019,34(12):1991-1994.18 王旋,崔立春,党升强.阿帕替尼联合放化疗对晚期胃癌疗效及肿瘤标志物的影响J.国际肿瘤学杂志,2021,48(10):602-607.19 何昌霞,丁德权,曹齐生,等.阿帕替尼联合化疗作为二线及以上方案治疗晚期胃癌或胃食管结合部腺癌的疗效观察J.中南医学科学杂志,2021,49(2):213-218.20 殷国庆,王忠,周峰,等.阿帕替尼辅助标准化疗对晚期胃癌合并肝