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Received:March 15, 2020 Published Online:December 20, 2020
Received:March 15, 2020 Published Online:December 20, 2020
中文摘要: 目的 比较数字化乳腺X射线摄影(钼靶，DM)、断层摄影(DBT)、超声检查(US)和磁共振成像(MRI)在乳腺癌中的诊断价值。方法 回顾性分析2018年1月至12月于南京医科大学附属肿瘤医院行乳腺手术的123例患者共128个病灶，术前均行DM、DBT、US和MRI检查，分析其影像学特征，与病理结果对比，比较四种检查方法对乳腺癌的敏感性、特异性和诊断准确率，并对各方法进行Kappa一致性检验。结果 DM、DBT、US和MRI对乳腺癌的敏感性、特异性及准确性分别为63.1%、59.6%和61.7%，88.1%、75.0%和82.8%，86.8%、76.9%和82.8%，93.4%、80.8%和88.3%，DBT、US和MRI对乳腺癌的敏感性和准确率高于DM，差异均有统计学意义(P<0.05)。DBT、US和MRI对乳腺癌的的敏感性和准确率差异均没有统计学意义(P>0.05)。MRI的特异性高于DM，差异有统计学意义(P<0.05)。DM、DBT和US对乳腺癌的特异性差异无统计学意义(P>0.05)。DM、DBT、US和MRI的 Kappa值分别为0.639、0.694、0.682、0.828。致密乳腺中65个非钙化性病变中，DM的诊断效能降低，敏感性和准确率分别是42.4%和50.8%。结论 DBT、US和MRI对乳腺癌的诊断效能高于DM，DBT和MRI具有更高的优势。
中文关键词: 乳腺癌 乳腺X射线摄影，钼靶 三维断层摄影 超声 磁共振
Abstract:Objective To investigate the clinical pathological feature, immunophenotype, differential diagnosis and prognosis of myxofibrosarcoma (MFS). Methods A total of 5 MFS patients who received treatment from February 2015 to March 2020 were selected.The clinical data of the patients were collected, and the clinicopathological features and immunophenotype were observed, and the related literature was reviewed. Results Among the 5 patients with MFS, 4 were males and 1 was female, with an average age of 70 years (58-83 years).Under the light microscope, the tumor grew in a nodular shape with fibrous connective tissue septum of varying thickness.The tumor cells were spindle shaped or star shaped.The characteristic pseudoadipoblasts and curved blood vessels were visible, and the stroma was mucinous.Immunohistochemistry showed that vimentin was expressed in tumor cells, but S-100, CD34, desmin, myoglobin, SMA and CD68 were not expressed. Conclusion MFS is an aggressive and recurrent soft tissue malignant tumor, which occurs frequently in middle-aged and elderly people.Its diagnosis should be combined with histopathological morphology, immunohistochemical markers and molecular pathological detection.Local extended resection is the main treatment for MFS.Postoperative radiotherapy and chemotherapy can be used to reduce the recurrence and metastasis rate.
文章编号： 中图分类号：R737.9，R445 文献标志码：B
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