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乳腺疾病的超声表现与病理特征的相关性。

The correlation between ultrasonographic findings and pathologic features in breast disorders.

机构信息

Department of Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.

出版信息

Jpn J Clin Oncol. 2010 Oct;40(10):905-12. doi: 10.1093/jjco/hyq070. Epub 2010 May 21.

Abstract

OBJECTIVE

Breast ultrasonography has gained widespread acceptance as a diagnostic tool for the evaluation of human breast disorders. It is important to evaluate the correlation of ultrasonography findings with the corresponding histopathological features.

METHOD

We retrospectively reviewed the 154 cases of breast disorders. We evaluated the correlation the ultrasonography findings and carcinoma cells extension with their corresponding histopathological findings. In addition, we also studied the information on estimation of histological types and cancer extension used by the other modalities such as computed tomography and magnetic resonance imaging.

RESULTS

The concordance rate for margins between ultrasonography findings and histopathological features was 91.6% (P < 0.001) and that for boundary zone was 87.0% (P < 0.001). Histopathological correlation of internal and posterior echoes demonstrated that internal low echo masses were composed of fibroblastic cells with marked collagenization in the stroma, or the cases in which carcinoma cells proliferated in a monotonous, solid and/or expanding manners. Attenuation of posterior echo was detected in the cases associated with hyperplasia of collagenized fibroblastic stroma. An increased cellularity in the mass with prominent large tumor nests and little fibrous stroma demonstrated the accentuation or no alterations of the posterior echo. The concordance rate of borders was 84.4% (P < 0.001). The correlation between estimated histological type by ultrasonography diagnosis and actual histological types was 87.0%. An overall detection rate of carcinoma extension by ultrasonography was 86.4%. In addition, an overall detection rate of carcinoma extension by ultrasonography, magnetic resonance imaging and computed tomography was 93.8%.

CONCLUSION

These results demonstrated correlation between histopathological and ultrasonographic findings of the breast lesions is cardinal for quality control or improving the quality of ultrasonography.

摘要

目的

乳腺超声已广泛应用于人类乳腺疾病的诊断。评估超声表现与相应组织病理学特征的相关性非常重要。

方法

回顾性分析了 154 例乳腺疾病患者的超声检查结果,评估超声表现与癌组织浸润的相关性,并与相应的组织病理学表现进行比较。此外,还研究了其他影像学方法(如 CT 和 MRI)在评估组织学类型和肿瘤浸润方面的信息。

结果

超声检查结果与组织病理学特征之间的边界一致性率为 91.6%(P<0.001),边界区一致性率为 87.0%(P<0.001)。内部和后方回声的组织病理学相关性表明,内部低回声肿块由间质中具有明显胶原化的成纤维细胞组成,或癌组织以单调、实性和/或扩张方式增生的情况。伴有胶原化成纤维基质增生的病例中,后方回声衰减。肿块内细胞密度增加,大肿瘤巢明显,纤维间质较少,后方回声增强或无改变。边界的一致性率为 84.4%(P<0.001)。超声诊断估计的组织学类型与实际组织学类型的相关性为 87.0%。超声对癌组织浸润的总体检出率为 86.4%。此外,超声、磁共振成像和 CT 对癌组织浸润的总体检出率为 93.8%。

结论

这些结果表明,乳腺病变的组织病理学和超声表现之间的相关性对于质量控制或提高超声质量至关重要。

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