根据雌激素受体状态，1187 例乳腺单纯导管原位癌患者的临床病理、乳腺钼靶及超声表现。
Clinicopathologic, mammographic, and sonographic features in 1,187 patients with pure ductal carcinoma in situ of the breast by estrogen receptor status.
机构信息
Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Unit 1473, 1515 Holcombe Blvd., Houston, TX 77030, USA.
出版信息
Breast Cancer Res Treat. 2013 Jun;139(3):639-47. doi: 10.1007/s10549-013-2598-7. Epub 2013 Jun 18.
The clinicopathologic, mammographic, and sonographic findings in patients with pure ductal carcinoma in situ (DCIS) were assessed by estrogen receptor (ER) expression. After institutional review board approval, patients with pure DCIS evaluated from January 1996 to July 2009 with known ER status and available imaging were identified. Images were reviewed as per the ACR BI-RADS(®) lexicon (4th edition). Clinical, pathologic, and imaging characteristics were analyzed by ER status using t test, Chi square test, and Fisher's exact test. Of 1,219 patients with pure DCIS and known ER status identified, 1,187 with complete data were included. Mammography was performed in all 1,187 patients and sonography in 519 (44 %). There were 972 (82 %) patients with ER-positive and 215 (18 %) with ER-negative disease. ER-negative DCIS was more likely to be high grade (93 vs 44 %, p < 0.0001), associated with comedonecrosis (64 vs 29 %, p < 0.0001), and multifocal (23 vs 15 %, p = 0.009). On sonography, ER-negative DCIS was more likely to be visible (61 vs 46 %, p = 0.004), larger (mean size, 2.3 vs 1.6 cm, p = 0.006), and show posterior shadowing (53 vs 28 %, p = 0.006). Mastectomy was more frequently performed for ER-negative DCIS (47 vs 37 %, p = 0.008). Palpable DCIS was visible on sonography in 55 % of cases and mammography in 81 %. Compared with ER-positive palpable DCIS, ER-negative palpable DCIS was larger and more likely to be visible on sonography. Compared with ER-positive noncalcified DCIS, ER-negative noncalcified DCIS was less likely to be visible on mammography. ER-positive and ER-negative pure DCIS have different clinicopathologic and imaging characteristics. ER-negative DCIS is associated with worse prognostic factors than ER-positive DCIS. On sonography, ER-negative DCIS is more frequently visible than ER-positive DCIS, tends to be larger, and more frequently demonstrates posterior shadowing.
本研究通过雌激素受体（ER）表达评估了单纯导管原位癌（DCIS）患者的临床病理、乳腺 X 线摄影术和超声表现。在机构审查委员会批准后，我们确定了 1996 年 1 月至 2009 年 7 月期间接受评估的、已知 ER 状态且具有可用影像学资料的单纯 DCIS 患者。按照 ACR BI-RADS®词汇（第 4 版）对图像进行了回顾。通过 ER 状态，采用 t 检验、卡方检验和 Fisher 精确检验分析了临床、病理和影像学特征。在 1219 例具有已知 ER 状态的单纯 DCIS 患者中，我们纳入了 1187 例具有完整数据的患者。所有 1187 例患者均行乳腺 X 线摄影术检查，519 例（44%）患者行超声检查。972 例（82%）患者为 ER 阳性，215 例（18%）患者为 ER 阴性。ER 阴性 DCIS 更可能为高级别（93%比 44%，p < 0.0001），与粉刺样坏死（64%比 29%，p < 0.0001）和多灶性（23%比 15%，p = 0.009）相关。在超声检查中，ER 阴性 DCIS 更易显示（61%比 46%，p = 0.004），更大（平均大小为 2.3 cm 比 1.6 cm，p = 0.006），并显示后向声影（53%比 28%，p = 0.006）。ER 阴性 DCIS 更常行乳房切除术（47%比 37%，p = 0.008）。在可触及的 DCIS 中，超声检查的检出率为 55%，乳腺 X 线摄影术的检出率为 81%。与 ER 阳性可触及 DCIS 相比，ER 阴性可触及 DCIS 更大，且更可能在超声检查中显示。与 ER 阳性非钙化 DCIS 相比，ER 阴性非钙化 DCIS 在乳腺 X 线摄影术上更不易显示。ER 阳性和 ER 阴性单纯 DCIS 具有不同的临床病理和影像学特征。ER 阴性 DCIS 与比 ER 阳性 DCIS 更差的预后因素相关。在超声检查中，ER 阴性 DCIS 比 ER 阳性 DCIS 更易显示，更倾向于更大，并更常显示后向声影。
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