Histopathological characteristics of breast ductal carcinoma in situ and association with imaging findings.
Histopathological characteristics of breast ductal carcinoma in situ and association with imaging findings.
复制标题
乳腺导管原位癌的组织病理学特征及其与影像学表现的关联。
DOI：
10.1007/s12282-015-0592-0
复制
发表时间：
2015
期刊：
影响因子：
4
通讯作者：
Masuda S.
中科院分区：
文献类型：
--
作者：
Tang X;Yamashita T;Hara M;Kumaki N;Tokuda Y;Masuda S.
背景乳腺导管原位癌（DCIS）的治疗策略在很大程度上取决于诊断的推广。然而，一个问题是，我们不能比较的影像学表现与组织病理学的DCIS。本研究的目的是探讨DCIS的组织病理学特征和与影像学findings.MethodSubjects的相关性，185例患者从东海大学医院，诊断与DCIS从2005年4月至2010年12月。超声检查的阳性结果定义为美国乳腺成像报告和数据系统（BI-RADS）3级或以上，乳房X线检查的阳性结果定义为日本乳腺癌协会2级或以上，MRI检查的阳性结果定义为BI-RADS-MRI 3级或以上。组织病理学上将扁平型和/或低乳头型DCIS分为1型，乳头型和/或筛状型DCIS分为2型，粉刺型和/或实性DCIS分为3型。（1）病理组织学上，第3型导管内癌细胞坏死和钙化的发生率较高扩张的导管周围毛细血管数大于1型（χ2，P< 0.001）（p= 0.023），DCIS的分布集中在3型（p= 0.020）;（2）在超声检查中，3型比1型更容易检测（p= 0.008）;（3）在乳腺X线摄影和MRI中，1型和3型之间没有显著差异。结论在对DCIS进行扩散性诊断时，应结合组织病理学类型，综合分析影像学表现，以提高诊断准确性。
BackgroundThe treatment policy for ductal cancer in situ (DCIS) of the breast greatly depends on the spreading diagnosis. However, a problem is that we cannot compare imaging findings with the histopathology of DCIS. The purpose of this study was to investigate the histopathological characteristics of DCIS and the association with imaging findings.MethodSubjects were 185 patients from Tokai University Hospital, diagnosed with DCIS from April 2005 to December 2010. A positive finding on ultrasonography was defined as Breast Imaging Reporting and Data System (BI-RADS) of US category 3 or above, in mammography it was Japan Breast Cancer Society category 2 or above, and in MRI it was BI-RADS-MRI category 3 or above. Histopathologically, we re-classified flat and/or low papillary DCIS into type 1; papillary and/or cribriform DCIS into type 2; and comedo and/or solid DCIS into type 3.ResultsThe clinical characteristics and association between imaging findings and histopathological classification of the 3 subtypes of DCIS are summarized as follows: (1) histopathologically, in type 3, there was a higher frequency of necrosis and calcification in the ducts of DCIS (χ2,p< 0.001), the number of dilated periductal capillaries was greater than in type 1 (p= 0.023), and the distribution of DCIS was concentrated in type 3 (p= 0.020); (2) on ultrasonography, type 3 was easier to detect than type 1 (p= 0.008); (3) on mammography and MRI, there were no significant differences between type 1 and type 3. The histopathological characteristics of small (<10 mm) DCIS and DCIS that cannot be detected by ultrasonography or MRI were also discussed.ConclusionWhen carrying out spreading diagnosis of DCIS, we need to keep the histopathological type in mind and interpret the imaging findings comprehensively.