乳腺柱状细胞病变与临床病理的关系(1)
摘 要：目的 探讨乳腺组织柱状细胞病变与临床病理的关系。方法 收集2013年～2017年我院收治的112例乳腺柱状细胞病变患者的临床病理资料，采用多个样本率(或构成比) 的比较(即：R×C表的χ2检验)及Pearson相关分析法，分析乳腺柱状细胞病变与临床病理的关系。结果 乳腺柱状细胞病变一般分为：柱状细胞变、柱状细胞增生、平坦上皮非典型性。以这三种组织学分类病变严重程度为趋势，发现其与患者的年龄无统计学差异(P>0.05)，但与发病部位有一定统计学差异(P<0.05)，本研究发现平坦上皮非典型性病变均发生于右侧乳腺。三种组织学分类与是否伴随硬化性腺病、导管内乳头状瘤、普通型导管上皮增生、非典型导管上皮增生、导管原位癌无统计学差异(P>0.05)，但与是否伴有纤维腺瘤和浸润癌有统计学差异(P<0.05)，其中病变发展与是否伴有纤维腺瘤呈负相关(相关系数r=-0.985，P<0.05)，与是否伴有浸润癌呈正相关(相关系数为r=0.823，P<0.05)。结论 乳腺平坦上皮非典型性病变发生于右侧乳腺居多。病变发展与是否伴有纤维腺瘤呈负相关，与是否伴有浸润癌呈正相关。
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关键词：乳腺；柱状细胞病变；纤维腺瘤；浸润性乳腺癌
中图分类号：R737.9 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.13.004
文章编号：1006-1959(2018)13-0013-04
Abstract：Objective To investigate the relationship between columnar cell lesions of breast tissue and clinicopathology.Methods The clinical and pathological data of 112 patients with breast columnar lesions admitted to our hospital from 2013 to 2017 were collected.The comparison of multiple sample rates(or composition ratios)(ie，χ2 test of R×C)and Pearson correlation analysis were used. The method was used to analyze the relationship between breast columnar lesions and clinical pathology.Results Breast columnar cell lesions are generally divided into：columnar cell changes，columnar cell proliferation，flat epithelial atypical.The severity of the lesions in these three histological categories was observed，and it was found to be no statistically different from the age of the patients(P>0.05)，However，there was a statistically significant difference with the location of the disease(P<0.05).This study found that atypical epithelial lesions occurred in the right breast.Three histological classifications were associated with sclerosing adenosis，intraductal papilloma， common ductal epithelial hyperplasia，atypical ductal epithelial hyperplasia，and ductal carcinoma in situ，there was no statistical difference(P>0.05)，but it was statistically different from whether there was fibroadenomas and invasive carcinoma(P<0.05).The development of lesions was negatively correlated with fibroadenomas(correlation coefficient r=-0.985，P<0.05)，positively correlated with invasive carcinoma(correlation coefficient was r=0.823，P<0.05).Conclusion Atypical lesions of the flat epithelium of the breast occur mostly in the right breast.The development of the lesion was negatively correlated with fibroid adenoma and positively associated with invasive carcinoma.
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Key words：Breast；Columnar cell lesion；Fibroadenoma；Invasive breast cancer
乳腺柱狀细胞病变是一种特殊上皮化生和(或)增生性病变，发生在终末导管小叶单位(terminalduct lobular units ， TDLUs)， 腺管可被覆不同状态的柱状细胞，从没有或只有轻度细胞或结构的不典型性， 到有明显不典型性， 甚至和不典型导管增生或导管原位癌不易区别，其原因和意义尚不清楚。病理学家对TDLU内柱状细胞病变的认识由来已久[1]，随着乳腺影像学筛查发现微钙化而进行活检的病例越来越多，这类病变的检出率也越来越多，从而引起再次关注[2-4]。根据其病变发展主要分为：柱状细胞变(columnar cell change，CCC)、柱状细胞增生(columnar cell hyperplasia，CCH)、平坦型上皮不典型性(flat epithelial atypia，FEA)[2，5-6]。CCC、CCH、FEA的腺管被覆不同状态的柱状细胞，从没有或只有轻度细胞或结构的不典型性， 到有明显不典型性，病变程度是相对越来越严重的，这三种分类可以同时并存，也可以与其他乳腺病变同时存在[8-10]。本研究旨在通过回顾性分析112例乳腺柱状细胞病变患者的临床病理资料，以这三种分类病变严重程度为趋势，分析乳腺柱状细胞病变与临床病理的关系。, http://www.100md.com(王露 赵苏苏 陈思敏 章宜芬)
, http://www.100md.com
关键词：乳腺；柱状细胞病变；纤维腺瘤；浸润性乳腺癌
中图分类号：R737.9 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.13.004
文章编号：1006-1959(2018)13-0013-04
Abstract：Objective To investigate the relationship between columnar cell lesions of breast tissue and clinicopathology.Methods The clinical and pathological data of 112 patients with breast columnar lesions admitted to our hospital from 2013 to 2017 were collected.The comparison of multiple sample rates(or composition ratios)(ie，χ2 test of R×C)and Pearson correlation analysis were used. The method was used to analyze the relationship between breast columnar lesions and clinical pathology.Results Breast columnar cell lesions are generally divided into：columnar cell changes，columnar cell proliferation，flat epithelial atypical.The severity of the lesions in these three histological categories was observed，and it was found to be no statistically different from the age of the patients(P>0.05)，However，there was a statistically significant difference with the location of the disease(P<0.05).This study found that atypical epithelial lesions occurred in the right breast.Three histological classifications were associated with sclerosing adenosis，intraductal papilloma， common ductal epithelial hyperplasia，atypical ductal epithelial hyperplasia，and ductal carcinoma in situ，there was no statistical difference(P>0.05)，but it was statistically different from whether there was fibroadenomas and invasive carcinoma(P<0.05).The development of lesions was negatively correlated with fibroadenomas(correlation coefficient r=-0.985，P<0.05)，positively correlated with invasive carcinoma(correlation coefficient was r=0.823，P<0.05).Conclusion Atypical lesions of the flat epithelium of the breast occur mostly in the right breast.The development of the lesion was negatively correlated with fibroid adenoma and positively associated with invasive carcinoma.
, http://www.100md.com
Key words：Breast；Columnar cell lesion；Fibroadenoma；Invasive breast cancer
乳腺柱狀细胞病变是一种特殊上皮化生和(或)增生性病变，发生在终末导管小叶单位(terminalduct lobular units ， TDLUs)， 腺管可被覆不同状态的柱状细胞，从没有或只有轻度细胞或结构的不典型性， 到有明显不典型性， 甚至和不典型导管增生或导管原位癌不易区别，其原因和意义尚不清楚。病理学家对TDLU内柱状细胞病变的认识由来已久[1]，随着乳腺影像学筛查发现微钙化而进行活检的病例越来越多，这类病变的检出率也越来越多，从而引起再次关注[2-4]。根据其病变发展主要分为：柱状细胞变(columnar cell change，CCC)、柱状细胞增生(columnar cell hyperplasia，CCH)、平坦型上皮不典型性(flat epithelial atypia，FEA)[2，5-6]。CCC、CCH、FEA的腺管被覆不同状态的柱状细胞，从没有或只有轻度细胞或结构的不典型性， 到有明显不典型性，病变程度是相对越来越严重的，这三种分类可以同时并存，也可以与其他乳腺病变同时存在[8-10]。本研究旨在通过回顾性分析112例乳腺柱状细胞病变患者的临床病理资料，以这三种分类病变严重程度为趋势，分析乳腺柱状细胞病变与临床病理的关系。, http://www.100md.com(王露 赵苏苏 陈思敏 章宜芬)