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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2019, Vol. 16 ›› Issue (08) : 592 -596. doi: 10.3877/cma.j.issn.1672-6448.2019.08.008

所属专题： 乳腺超声； 文献；

浅表器官超声影像学

乳腺原发性鳞状细胞癌的临床病理与超声表现特征
王晓艳1,†(), 吴佳玲1, 石键1   
  1. 1. 116011　大连医科大学附属第一医院超声科
  • 收稿日期:2017-08-26 出版日期:2019-08-01
  • 通信作者: 王晓艳

Clinicopathological and ultrasonographic features of primary squamous cell carcinoma of the breast

Xiaoyan Wang1,†(), Jialing Wu1, Jian Shi1   

  1. 1. Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
  • Received:2017-08-26 Published:2019-08-01
  • Corresponding author: Xiaoyan Wang
  • About author:
    Corresponding author: Wang Xiaoyan, Email:
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王晓艳, 吴佳玲, 石键. 乳腺原发性鳞状细胞癌的临床病理与超声表现特征[J]. 中华医学超声杂志（电子版）, 2019, 16(08): 592-596.

Xiaoyan Wang, Jialing Wu, Jian Shi. Clinicopathological and ultrasonographic features of primary squamous cell carcinoma of the breast[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2019, 16(08): 592-596.

目的

总结乳腺原发性鳞状细胞癌的临床病理特征与超声表现特征。

方法

回顾性分析1998年1月至2016年1月大连医科大学附属第一医院收治的经病理检查证实的乳腺原发性鳞状细胞癌患者12例，共12个病灶。采用t检验比较有无淋巴结转移、有无雌激素受体（ER）、孕激素受体（PR）表达患者超声评分差异；采用方差分析比较不同分化类型、Dukes分期患者超声评分差异。

结果

所有患者均发现乳腺肿块，5例患者肿块周围有卫星结节。12例患者中，乳房各象限均有肿块分布。超声检查提示，12个病灶中，9个为低回声，3个为混合回声；12个病灶均边界模糊且形状不规则，7个病灶内呈囊腔样，4个病灶钙化。彩色多普勒血流成像显示，5个、2个、2个、3个病灶分别测及1级、2级、3级、4级血流信号。12个病灶彩色多普勒血流成像超声评分为（3.5±0.1）分。有无淋巴结转移、不同分化类型、Dukes分期病灶超声评分差异有统计学意义（t=10.933、F=3.099、F=4.133，P均<0.05），而有无ER、PR表达病灶超声评分差异无统计学意义（t=0.433、0.378，P均>0.05）。

结论

乳腺原发性鳞状细胞癌的临床病理特征有其特异性，超声检查显示肿瘤内部有较多囊性成分及丰富的血流，这有助于临床对乳腺原发性鳞状细胞癌的诊断。

关键词: 乳腺肿瘤, 癌，鳞状细胞, 病理学, 超声检查
Objective

To summarize the clinicopathological and ultrasonographic features of primary squamous cell carcinoma of the breast.

Methods

From January 1998 to January 2016, 12 patients with 12 lesions of primary squamous cell carcinoma of the breast confirmed by pathological examination at the First Affiliated Hospital of Dalian Medical University were selected. The t-test were used to compare the differences in ultrasound scores in patients with and without lymph node metastasis, ER expression, and PR expression. Variance analysis was used to compare the differences in ultrasound scores between patients with different differentiation types and those with Dukes stages.

Results

All patients were found to have a breast mass, and 5 patients had satellite nodules around the mass. The mass may be located in each quadrant of the breast. Ultrasound examination showed that among the 12 lesions, 9 were hypoechoic and 3 had mixed echoes; 12 lesions had unclear border and irregular shape, 7 were cystic, and 4 had calcification. Color Doppler flow imaging showed that 5, 2, 2, and 3 lesions had grades 1, 2, 3, and 4 blood flow signals, respectively. The score of color Doppler flow imaging in 12 lesions was (3.5±0.1) points, and there were significant differences in ultrasound scores between patients with and without lymph node metastasis, patients with different differentiation types, and those with different Dukes stages (t=10.933, F=3.099, F=4.133, all P<0.05), but there were no difference in ultrasound scores between with and without ER and PR expression (t=0.433, 0.378, both P>0.05).

Conclusion

The clinicopathological characteristics of primary squamous cell carcinoma of the breast are specific. Ultrasound diagnosis shows that the tumor has more cystic components and rich blood flow, which can contribute to the clinical diagnosis of this malignancy.

Key words: Primary neoplasms, Carcinoma, squamous cell, Pathology, Ultrasonography
图1 乳腺原发性鳞状细胞癌病理表现。图a、b示癌组织内角化珠形成；图c、d示乳腺组织中鳞状细胞浸润
图2 乳腺原发性鳞状细胞癌超声声像图。图a示病灶内多囊腔；图b示病灶内1级血流信号；图c、d示病灶内低回声
表1 不同临床病理特征乳腺原发性鳞状细胞癌超声评分比较（分，±s）
病理特征 病灶个数 超声评分 统计值 P值
淋巴结转移 ? ? t=10.933 <0.05
? 有 3 3.9±0.5 ? ?
? 无 9 2.6±0.6 ? ?
? ER ? ? t=0.433 >0.05
? 阳性 10 3.7±0.5 ? ?
? 阴性 2 3.3±0.4 ? ?
? PR ? ? t=0.378 >0.05
? 阳性 9 3.7±0.5 ? ?
? 阴性 3 3.4±0.5 ? ?
Dukes分期 ? ? F=3.099 <0.05
? Ⅱ期 6 3.2±0.3 ? ?
? Ⅲ期 4 3.6±0.4 ? ?
? Ⅳ期 2 4.0±0.2 ? ?
分化类型 ? ? F=4.133 <0.05
? 高分化 9 3.1±0.5 ? ?
? 中分化 2 3.5±0.5 ? ?
? 低分化 1 3.9±0.5 ? ?
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