Abstract
目的 评价乳腺导管原位癌(DCIS)及DCIS伴微浸润的X线片表现,分析X线表现与预后生物学标记的相关性.方法 对50例乳腺DCIS及45例DCIS伴微浸润的患者行X线检查,共62例行预后生物学标记,分析影像表现与孕激素受体(PR)、癌基因(C-erbB-2)、抑癌基因(p53)的相关性.用卡方检验进行统计学处理,并对有意义者行优势比(OR值)分析.结果 (1)单独1个X线征象表现者62例;合并2个征象26例;阴性7例.(2)各种X线征象单独分析显示,62例有钙化的病灶中恶性钙化占73%(45例),其余为中间性钙化;钙化以簇状分布最为常见(36例),其次为段样分布(18例).22例有肿块的病灶中,以卵圆形肿块最为常见(13例);肿块的边缘表现为浸润、小分叶、清晰和模糊各为15、1、4和2例;等密度肿块占的比例较高(55%,12例).结构扭曲7例,除1例外多与其他征象伴行;局灶性不对称占16%(15/95),可单独发生或与其他征象伴发.(3)将病灶的X线表现分成恶性钙化、中间性钙化和非钙化3组,PR与C-erbB-2在3组中的分布有统计性意义,PR阳性表达者X线上非钙化征象发生率是中间性钙化的11.00倍[χ2=8.571,P=0.003;95%可信区间(CI)为1.998～60.572]、恶性钙化的8.80倍(χ2=9.748,P=0.002;95% CI为2.024～38.253);而C-erbB-2高表达者,恶性钙化是非钙化发生的12.35倍(χ2=7.353,P=0.007;95% CI为1.447～105.443),中间性钙化的5.74倍(χ2=4.977,P=0.026;95% CI为1.110～29.645).结论 乳腺DCIS及DCIS伴微浸润X线征象有特征.X线征象可以作为早期乳腺DCIS的一个预后因子。
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