1、第 43 卷 第 6 期2023 年 06 月Vol.43 NO.6JUN.2023赣南医学院学报JOURNAL OF GANNAN MEDICAL UNIVERSITY投稿网址：http：/16例炎性乳腺癌患者钼靶X线表现特征及病理结果分析徐丽华1，洪慧勤2，高春茗2，刘金萍3，刘华之1（1.赣南医学院第一附属医院院感科；2.赣南医学院第一附属医院急诊科；3.赣南医学院第一附属医院重症医学科三区，江西赣州3410010）摘 要：目的：研究16例炎性乳腺癌（Inflammatory breast cancer，IBC）患者钼靶X线表现及病理结果，为该病患者的早期诊治提供参考依据。方法：回顾性分
2、析从2019年1月至2021年10月于我院接受诊治的16例IBC患者病历资料。分析患者钼靶X线表现、病理结果以及免疫组化检查结果，并以病理结果为金标准，将所有IBC患者按照钼靶X线诊断结果的差异分为真阳性组12例以及假阴性组4例。比较两组患者临床病理特征及免疫组化检查结果。结果：16例IBC患者钼靶X线表现：（1）5例患者皮肤增厚，后缘模糊不清，且伴有乳头内陷；（2）皮下脂肪层密度明显增高，9例患者可见显著增粗的Coopers韧带；（3）腺体增厚，结构紊乱，3例在腺体内见明显形态不规则的肿块，其中1例伴有沙粒样钙化，10例未发现显著肿块，4例伴有弥漫分布的沙粒样钙化灶；（4）同侧腋窝均伴有淋巴
3、结肿大，结构致密，边缘相对清晰。16例IBC患者均经病理诊断确诊为浸润性导管癌；其中6例皮肤内可见明显淋巴管癌栓；钼靶X线诊断炎性乳腺癌真阳性12例，假阴性4例。16例IBC患者经免疫组化检查结果显示：雌激素受体（Estrogen receptor，ER）阳性 8 例，占比 50.00%，孕激素受体（Progesterone receptor，PR）阳性 7 例，占比43.75%，P53阳性10例，占比62.50%。钼靶X线假阴性IBC患者肿块大小5 cm、TNM分期为期以及无淋巴结转移人数占比均高于真阳性患者（P均0.05）。钼靶X线假阴性及真阳性IBC患者ER、PR及P53阳性人数占比差异
4、无统计学意义（P均0.05）。结论：IBC患者钼靶X线表现及病理结果均有一定的特征性，两者可为IBC的临床诊断提供参考。关键词：炎性乳腺癌；钼靶X线；病理分析；免疫组化；假阴性中图分类号：R730.43 文献标志码：A 文章编号：1001-5779（2023）06-0599-05 DOI:10.3969/j.issn.1001-5779.2023.06.009Molybdenum target X-ray features and pathological results of 16 patients with inflammatory breast cancerXU Li-hua1，HONG
5、 Hui-qing2，GAO Chun-ming2，LIU Jin-ping3，LIU Hua-zhi1（1.Hospital-Acquired Infection Control Department，The First Affiliated Hospital of Gannan Medical University；2.Department of Emergency，The First Affiliated Hospital of Gannan Medical University；3.Area 3，Department of Intensive Medicine，The First Af
6、filiated Hospital of Gannan Medical University，Ganzhou，Jiangxi 341000）Abstract :Objective :To study the molybdenum target X-ray manifestations and pathological results of 16 patients with inflammatory breast cancer（IBC）to provide reference for early diagnosis and treatment of this disease.Methods :T
7、he medical records of 16 patients with IBC who were treated in the hospital from January 2019 to October 2021 were analyzed retrospectively.The molybdenum target X-ray manifestations，pathological results and immunohistochemical results of 16 patients with IBC were analyzed.Taking the pathological re
8、sults as the gold standard，all patients with IBC were divided into the true positive group(12 cases)and the false negative group(4 cases)according to the difference of molybdenum target X-ray diagnosis results.The clinicopathological features and immunohistochemical findings of the two groups were c
9、ompared.Results :The X-ray manifestations of molybdenum target in 16 patients with IBC were as follows：（1）5 patients 基金项目：赣州市指导性科技计划项目（GZ2014ZSF037）作者简介：徐丽华，女，学士，副主任医师，研究方向：医学影像学、新冠疫苗接种等。E-mail：通信作者：刘华之，女，学士，主任护师，研究方向：医院感染预防与控制。E-mail： 5992023 年赣 南 医 学 院 学 报投稿网址：http：/had thickened skin，blurred post
10、erior edge and inverted nipple.（2）The density of subcutaneous fat layer was significantly increased，and the significantly thickened Coopers ligament was seen in 9 patients.（3）The glands were thickened and structurally disordered.Irregular masses were found in 3 cases，including 1 case with sandy calc
11、ification，10 cases without significant masses，and 4 cases with diffuse sandy calcification.（4）The ipsilateral armpits were accompanied by enlarged lymph nodes，with dense structure and relatively clear edges.All 16 patients with IBC were diagnosed as invasive ductal carcinoma by pathology.There were
12、obvious lymphatic tumor thrombi in 6 cases.Molybdenum target X-ray diagnosis of inflammatory breast cancer is true positive in 12 cases，false negative in 4 cases.The results of immunohistochemical examination of 16 patients with IBC showed that 8 cases were positive for estrogen receptor（ER），account
13、ing for 50.00%，7 cases were positive for progesterone receptor（PR），accounting for 43.75%，and 10 cases were positive for p53，accounting for 62.50%.The proportion of tumor size 5cm，TNM stage I and no lymph node metastasis in patients with false negative molybdenum target X-ray IBC were 100.00%，which w
14、ere higher than those of true positive patients（all P0.05）.The proportion of ER，PR and P53 positive in patients with IBC with false negative and true positive molybdenum target X-ray was not statistically significant（all P0.05）.Conclusion :The molybdenum target X-ray manifestations and pathological
15、results of patients with IBC have certain characteristics，which can provide reference for the clinical diagnosis of IBC.Key words :Inflammatory breast cancer；Molybdenum target X-ray；Pathological analysis；Immunohistochemistry；False negative炎性乳腺癌（Inflammatory breast cancer，IBC）属于临床上较为少见的乳腺癌类型之一，其具有发病急
16、、恶性程度高以及预后较差等临床特点，该病患者临床表现与乳腺炎高度相似，因此又被称为急性乳腺癌以及癌性乳腺炎等，现已成为严重威胁人类生命健康安全的生殖系统恶性肿瘤之一1。随着临床研究的日益深入，越来越多学者开始重视 IBC，而IBC病理表现多样，在肿瘤的微环境中可表现出不同特质，如血管及淋巴管生成、免疫细胞浸润等，对患者造成严重影响，且作为乳腺癌的特殊类型之一，致死率极高2-3，因此，如何早期诊断并对IBC患者进行有效治疗已得到广泛关注。病理检查是迄今为止国内外公认的诊断IBC金标准，但其属于有创性检查，加之对患者耐受性要求较高，不利于临床推广普及4。钼靶X线是诊断乳腺癌的重要影像学手段，具有无创、便捷且辐射剂量较小等特点，现已在临床上广泛运用，然而，该检查手段的表现存在多变性，且在一定程度上受多种主观因素的影响，继而可能出现假阴性或假阳性情况5-6。鉴于此，本文通过分析16例IBC患者钼靶X线表现及病理结果，为该病患者的早期诊治提供参考依据。1 资料与方法 1.1一般资料 回顾性分析从2019年1月至2021年10月于我院接受诊治的16例IBC患者病历资料。年龄3172岁，平均（50.