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目的:研究乳腺X线摄影癌周透亮带影像学特征,分析其病理基础及临床意义。方法:回顾性分析2010年6月-2011年10月期间我院经手术病理证实为乳腺癌患者196例,筛选出术前进行过乳腺X线摄影检查并且图像上癌周出现透亮带征象的患者共47例51个病灶,测量肿块直径、癌周透亮带宽度等,与病理大体标本切面和镜下切片进行对比研究分析。结果:双乳病灶多分布于外上象限(19/51),临床触诊病灶大小平均值约35.45±1.25 mm。乳腺X摄影观察病灶均为肿块样,影像测量病灶大小平均值约20.49±1.18 mm,与临床触诊大小之间的差别具有统计学意义(t=2.85,P<0.01);肿块周围可观察到宽窄不均透亮带,平均宽度约15.07±0.86 mm,乳腺癌癌周透亮带宽度与肿块大小之间没有显著相关性(r=0.188,P=0.186)。病理大体标本观察病灶周围包绕一圈连续的黄色脂肪组织;HE染色镜下切片观察瘤灶周围为一圈成熟脂肪细胞,局部被瘤灶边缘增生的致密结缔组织为主的毛刺分割,脂肪组织中散在分布炎性细胞,部分区域见灶状癌细胞团浸润。结论:乳腺X线摄影癌周透亮带病理基础为伴随瘤周间质反应的富含脂肪的组织层,此征象对乳腺癌的诊断、以及临床评估肿瘤浸润范围具有一定意义。
Objective: To study the imaging features of transabdominal radiographs of mammography and analyze its pathological basis and clinical significance. Methods: A retrospective analysis of 196 cases of breast cancer confirmed by operation and pathology in our hospital from June 2010 to October 2011 was performed. Patients who had undergone mammography before operation and showed signs of translucent bands on their cancer were included A total of 47 cases of 51 lesions, measurement of tumor diameter, cancer week translucent band width, with pathological gross specimen section and microscopic sections for comparative study. Results: The distribution of breast lesions in the upper quadrant (19/51), the average size of the clinical palpation lesions was about 35.45 ± 1.25 mm. The size of the lesion was about 20.49 ± 1.18 mm, which was statistically different from the clinical palpation size (t = 2.85, P <0.01) The average width of translucent bands was 15.07 ± 0.86 mm. There was no significant correlation between the width of translucent bands and tumor size (r = 0.188, P = 0.186). Pathological specimens were observed around the lesion surrounded by a continuous circle of yellow adipose tissue; HE staining under the microscope to observe the tumor around the circle of mature adipocytes, the local edge of the lesion edge of dense connective tissue-based burr segmentation, adipose tissue In the scattered distribution of inflammatory cells, some areas see the tumor-like tumor cell infiltration. Conclusion: The pathological basis of transabdominal radiolucent mammography is a fat-rich tissue layer associated with peritumoral stromal reaction. This phenomenon has some significance for the diagnosis of breast cancer and the clinical assessment of the extent of tumor infiltration.