三阴性乳腺癌超声征象与临床特征的关系研究

黄琼 华山 石颖芳

【摘要】 目的：探讨三阴性乳腺癌（TNBC）超声征象与临床特征的关系。方法：选取2016年1月-2017年12月首诊由九江市第一人民医院确诊为乳腺癌但转至江西省人民医院的89例患者为研究对象，按照类型不同分为TNBC组（n=38）和非TNBC组（n=51），患者均进行超声检查，并分析超声征象与临床特征的关系。结果：两组临床分期、年龄及病理类型等临床特征比较，差异均无统计学意义（P>0.05）；TNBC组钙化灶、毛刺征均少于非TNBC组，淋巴结转移率高于非TNBC组，比较差异均有统计学意义（P<0.05）；两组血管形态分布、增强强度及增强边界情况比较，差异均有统计学意义（P<0.05）。结论： TNBC在超声特征中与周围组织分界较清楚，临床淋巴结转移率较高，超声征象与临床特征关系密切。

【关键词】 超声； 三阴乳腺癌； 临床特征

【Abstract】 Objective：To investigate the relationship between ultrasonographic features and clinical features of three negative breast cancer（TNBC）.Method：A total of 89 patients with breast cancer who were first diagnosed in Jiujiang First Peoples Hospital but transferred to Jiangxi Provincial Peoples Hospital from January 2016 to December 2017 were selected as subjects.According to the difference types，they were divided into TNBC group（n=38） and non-TNBC group（n=51）.Ultrasound examination was performed and the relationship between ultrasound signs and clinical features was analyzed.Result：The clinical characteristics of two groups were compared with clinical stages，ages and pathological types，the differences were not statistically significant（P>0.05）.The calcification and burr symptoms in TNBC group were less than those of non-TNBC group，and lymph node metastasis rate was higher than that of non-TNBC group，the differences were statistically significant（P<0.05）.The blood vessel morphology distribution，enhancement strength and enhancement boundary condition in two groups were compared，the differences were statistically significant（P<0.05）.Conclusion：TNBC has a clear demarcation with surrounding tissues，a high rate of clinical lymph node metastasis，and the ultrasonographic features are closely related to clinical features.

【Key words】 Ultrasonography； Three negative breast cancer； Clinical features

First-authors address：Jiujiang First Peoples Hospital，Jiujiang 332000，China

doi：10.3969/j.issn.1674-4985.2018.33.011

乳腺癌是臨床上最为常见的女性恶性肿瘤之一，其发病率较高，40～50岁的中年女性是高发群体[1]。早期乳腺癌并无明显体征症状，易被忽视，多数患者通过体检等检查才确诊，其临床主要表现为非妊娠期乳头有液体流出、乳房出现肿块及皮肤改变等[2]。乳腺癌的发病机制目前暂无统一认识，但通常认为大龄、月经初潮早、经常行胸部放射检查、家族遗传史、绝经晚、过量饮酒及晚育未婚等女性易患乳腺癌[3]。三阴性乳腺癌（TNBC）属于乳腺癌一种比较特殊的类型，因患者的孕激素受体（PR）、人表皮生长因子受体（HER2）及雌激素受体（ER）三者均呈阴性，故被命名为TNBC[4]。与非TNBC相比，TNBC侵袭性强，患者预后较差，死亡率更高，因此对其进行早期诊断，并及时治疗显得十分重要[5]。临床上可通过超声、CT及MRI等手段对乳腺癌检查诊断，其中超声学检查是初筛的重要手段之一，在TNBC的诊断中有着较高的价值[6]。本研究旨在分析TNBC与非TNBC的超声征象及临床特征，以期为TNBC诊疗提供帮助。现……