Dinkel H P, Gassel A M, Tschammler A
Department of Radiology, University of Würzburg, Germany.
Br J Radiol. 2000 Sep;73(873):938-44. doi: 10.1259/bjr.73.873.11064645.
It has been proposed that the grade of malignancy of ductal carcinoma in situ (DCIS) of the breast can be estimated by the morphology of microcalcifications found on mammography. We correlated microcalcifications and histopathology in a retrospective blinded review. We reviewed all patients who underwent excisional breast biopsy over a 5 1/2-year period. Mammograms and pathology slides of all patients (n = 49) with DCIS of the breast were included in a blinded retrospective analysis. Mammographic microcalcifications were divided into four categories, "linear branching", "coarse granular", "fine granular" or "no microcalcification". Independently, pathology specimens were assigned to poorly, intermediately and well differentiated categories according to the consensus classification of DCIS introduced by the European Organisation for the Research and Treatment of Cancer. Two patients had no microcalcifications. 25 (53%) of the remaining 47 patients had "linear branching" microcalcifications, 10 (21%) had "coarse granular" and 12 (25.5%) had "fine granular" microcalcifications. 19 patients (40%) had poorly differentiated, 23 (49%) intermediately differentiated and 5 (11%) well differentiated subtypes of DCIS. 14 (56%) of the 25 patients with "linear branching" microcalcifications had poorly differentiated DCIS, 10 (40%) had intermediately differentiated and 1 (4%) had well differentiated DCIS. 3 (30%) of 10 patients with "coarse granular" microcalcifications had poorly differentiated DCIS, 5 (50%) had intermediately differentiated and 2 (20%) had well differentiated DCIS. 2 (17%) of 12 patients with "fine granular" microcalcifications had poorly differentiated DCIS, 8 (67%) had intermediately differentiated and 2 (17%) had well differentiated DCIS. These findings were not statistically significant. In conclusion, "linear branching" microcalcifications tended to be associated with higher pathological grading. However, correlation was poor and there was considerable overlap between categories. Histological type of DCIS cannot be predicted prospectively on mammographic appearances.
有人提出，乳腺导管原位癌（DCIS）的恶性程度可通过乳腺钼靶检查发现的微钙化形态来估计。我们在一项回顾性双盲研究中对微钙化与组织病理学进行了相关性分析。我们回顾了在5年半时间内接受乳腺切除活检的所有患者。所有乳腺DCIS患者（n = 49）的乳腺钼靶片和病理切片都纳入了双盲回顾性分析。乳腺钼靶微钙化分为四类：“线性分支状”、“粗大颗粒状”、“细小颗粒状”或“无微钙化”。独立地，根据欧洲癌症研究与治疗组织引入的DCIS共识分类，将病理标本分为低分化、中分化和高分化类别。两名患者无微钙化。其余47名患者中，25名（53%）有“线性分支状”微钙化；10名（21%）有“粗大颗粒状”微钙化；12名（25.5%）有“细小颗粒状”微钙化。19名患者（40%）为低分化DCIS亚型，23名（49%）为中分化，5名（11%）为高分化。25名有“线性分支状”微钙化的患者中，14名（56%）为低分化DCIS，10名（40%）为中分化，1名（4%）为高分化。10名有“粗大颗粒状”微钙化的患者中，3名（30%）为低分化DCIS，5名（50%）为中分化，2名（20%）为高分化。12名有“细小颗粒状”微钙化的患者中，2名（17%）为低分化DCIS，8名（67%）为中分化，2名（17%）为高分化。这些结果无统计学意义。总之，“线性分支状”微钙化往往与更高的病理分级相关。然而，相关性较差，类别之间有相当大的重叠。不能根据乳腺钼靶表现前瞻性地预测DCIS的组织学类型。
