吉林大学学报(医学版) ›› 2019, Vol. 45 ›› Issue (02): 450-456.doi: 10.13481/j.1671-587x.20190243
丁荣波1, 张海鹏2, 申李胜男1, 韩冰1
收稿日期:2018-08-25
出版日期:2019-03-28
发布日期:2019-03-29
通讯作者:
韩冰,教授,主任医师,硕士研究生导师(Tel:0431-88782284,E-mail:yintian77@163.com)
E-mail:yintian77@163.com
作者简介:丁荣波(1990-),男,山西省运城市人,在读医学硕士,主要从事乳腺癌诊治及预后评估等方面的研究。
基金资助:
Received:2018-08-25
Online:2019-03-28
Published:2019-03-29
摘要: 钙化是乳腺癌常见的影像学特征之一。乳腺癌中的钙化灶除了在其检测中扮演着很重要的角色之外,同时还可以传递重要的预后信息。浸润性导管癌和导管原位癌中的钙化灶与不良预后有关,且钙化可以作为判断乳腺癌患者预后的指标之一。目前对于乳腺癌普遍公认的3个常用评估预后指标有肿瘤大小、淋巴结转移情况和组织病理学类型。伴有钙化灶的乳腺癌预后通常与Her-2受体表达率升高、患者存活率降低、复发风险增加、高组织学分级和腋窝淋巴结转移的可能性增加等因素有关联。乳腺癌钙化灶是临床影像学特征中很重要的发现,且对钙化灶形成的进一步理解可能会提高对乳腺癌形成的认知。本文通过回顾近年来有关乳腺癌钙化灶的相关研究,总结乳腺癌中钙化灶的形成、影像学特征、病理指标及其与预后的关系。
中图分类号:
丁荣波, 张海鹏, 申李胜男, 韩冰. 乳腺癌钙化灶与其临床、病理特征和预后关系的研究进展[J]. 吉林大学学报(医学版), 2019, 45(02): 450-456.
| [1] MILLER K D, SEEGEL R L, LIN C C, et al. Cancer treatment and survivorship statistics, 2016[J].Cancer J Clin, 2016, 66(4):271-289. [2] NAROD S A, IQBAL J, MILLER A B.Why have breast cancer mortality rates declined?[J].J Cancer Policy, 2015, 5:8-17. [3] DESANTIS C, MA J M, BRYAN L, et al.Breast Cancer Statistics, 2013[J].Cancer J Clin, 2014, 64(1):52-62. [4] MAXWELL AJ, CLEMENTS K, HILTON B, et al.Risk factors for the development of invasive cancer in unresected ductal carcinoma in situ[J].Eur J Surg Oncol, 2018, 44(4):429-435. [5] NASEEM M, MURRAY J, HILTON J F, et al.Mammographic microcalcifications and breast cancer tumorigenesis:A radiologic-pathologic analysis[J].BMC Cancer, 2015, 15:307. [6] QI X M, CHEN A X, ZHANG P, et al.Mammographic calcification can predict outcome in women with breast cancer treated with breast-conserving surgery[J].Oncol Lett, 2017, 14(1):79-88. [7] LIBERMAN L, VAN Z K J, DERSHAW D D, et al.Mammographic features of local recurrence in women who have undergone breast-conserving therapy for ductal carcinoma in situ[J].Am J Roentgenol, 1997, 168(2):489-493. [8] MÅNSSON E, BERGKVIST L, CHRISTENSON G, et al.Mammographic casting-type calcifications is not a prognostic factor in unifocal small invasive breast cancer:A population-based retrospective cohort study[J].J Surg Oncol, 2009, 100(8):670-674. [9] HAKA AS, SHAFER-PELTIER K E, FITZMAURICE M, et al.Diagnosing breast cancer by using Raman spectroscopy[J].Proc Natl Acad Sci USA, 2005, 102(35):12371-12376. [10] KHARKWAL S, SAMEER, MUKHERJEE A.Triple test in carcinoma breast[J].J Clin Diagn Res, 2014, 8(10):NC09-NC11. [11] TSE G M, TAN P H, CHEUNG H S, et al.Intermediate to highly suspicious calcification in breast lesions:a radio-pathologic correlation[J].Breast Cancer Res Treat, 2008, 110(1):1-7. [12] KUMAR V, COTRA N, ROBBIN S.Robbins basic pathology[M].7thed.Philadelphia:Saunders, 2003:21-22. [13] HAKA A S, SHAFER-PELTIER K E, FITZMAURICE M, et al.Identifying microcalcifications in benign and malignant breast lesions by probing differences in their chemical composition using Raman spectroscopy[J].Cancer Res, 2002, 62(18):5375-5380. [14] MORGAN M P, COOKE M M, CHRISTOPHERSON P A, et al.Calcium hydroxyapatite promotes mitogenesis and matrix metalloproteinase expression in human breast cancer cell lines[J].Mol Carcinog, 2001, 32(3):111-117. [15] COX R F, HERNANDEZ-SANTANA A, RAMDASS S, et al.Microcalcifications in breast cancer:novel insights into the molecular mechanism and functional consequence of mammary mineralisation[J].Br J Cancer, 2012, 106(3):525-537. [16] PSYRRI A, KALOGERAS K T, WIRTZ R M, et al.Association of osteopontin with specific prognostic factors and survival in adjuvant breast cancer trials of the Hellenic Cooperative Oncology Group[J].J Transl Med, 2017, 15(1):30. [17] DIEL I J, SOLOMAYER E F, SEIBEL M J, et al.Serum bone sialoprotein in patients with primary breast cancer is a prognostic marker for subsequent bone metastasis[J].Clin Cancer Res, 1999, 5(12):3914-3919. [18] SATO K, AKIMOTO K.Expression levels of KMT2C and SLC20A1 identified by information-theoretical analysis are powerful prognostic biomarkers in estrogen receptor-positive breast cancer[J].Clin Breast Cancer, 2017, 17(3):e135-e142. [19] YEPES M M, ROMILLY A P, COLLADO-MESA F, et al.Can mammographic and sonographic imaging features predict the oncotype DX (TM) recurrence score in T1 and T2, hormone receptor positive, HER2 negative and axillary lymph node negative breast cancers?[J].Breast Cancer Res Treatment, 2014, 148(1):117-123. [20] WOODARD G A, RAY K M, JOE B N, et al.Qualitative radiogenomics:Association between Oncotype DX test recurrence score and BI-RADS mammographic and breast MR imaging features[J].Radiology, 2018, 286(1):60-70. [21] CHAE E Y, MOON W K, KIM H H, et al.Association between ultrasound features and the 21-gene Recurrence Score Assays in Patients with oestrogen receptor-positive, HER2-negative, invasive breast cancer[J].PLoS ONE, 2016,11(6):e0158461. [22] SHIN S U, LEE J, KIM J H, et al.Gene expression profiling of calcifications in breast cancer[J].Sci Rep, 2017, 7(1):11427. [23] LE GAL M, CHAVANNE G, PELLIER D.Diagnostic value of clustered microcalcifications discovered by mammography (apropos of 227 cases with histological verification and without a palpable breast tumor)[J].Bull Cancer, 1984, 71(1):57-64. [24] OBENAUER S, HERMANN K P, GRABBE E.Applications and literature review of the BI-RADS classification[J].Eur Radiol, 2005, 15(5):1027-1036. [25] RAO A A, FENEIS J, LALONDE C, et al.A pictorial review of changes in the BI-RADS Fifth Edition[J].Radiographics, 2016, 36(3):623-639. [26] ROMINGER M, WISGICKL C, TIMMESFELD N.Breast microcalcifications as type descriptors to Stratify risk of Malignancy:a Systematic review and Meta-analysis of 10665 cases with special focus on round/punctate microcalcifications[J].Rofo, 2012, 184(12):1144-1152. [27] BENT CK, BASSETT LW, D'ORSI CJ, et al.The positive predictive value of BI-RADS microcalcification descriptors and final assessment categories[J].AJR Am J Roentgenol, 2010, 194(5):1378-1383. [28] ARANCIBIA HEMANDEZ P L, TAUB ESTRADA T T, LOPEZ PIZARRO A, et al.Calcificaciones mamarias:descripción y clasificación según la 5.a edición BI-RADS[J].Revista Chilena De Radiología, 2016, 22(2):80-91. [29] ÇELEBI F, PILANCI K N, ORDU C, et al.The role of ultrasonographic findings to predict molecular subtype, histologic grade, and hormone receptor status of breast cancer[J].Diagn Interv Radiol, 2015, 21(6):448-453. [30] LING H, LIU Z B, XU L H.Malignant calcification is an important unfavorable prognostic factor in primary invasive breast cancer[J].Asia Pac J Clin Oncol, 2013, 9(2):139-145. [31] ZHENG K, TAN J X, LI F, et al.Relationship between mammographic calcifications and the clinicopathologic characteristics of breast cancer in Western China:a retrospective multi-center study of 7317 female patients[J].Breast Cancer Res Treat, 2017, 166(2):569-582. [32] WANG X, CHAO L, CHEN L, et al.Correlation of mammographic calcifications with HER-2/neu overexpression in primary breast carcinomas[J].J Digit Imaging, 2008, 21(2):170-176. [33] KARAMOUZIS M V, LIKAKI-KARATZA E, RAVAZOULA P, et al.Non-palpable breast carcinomas:Correlation of mammographically detected malignant-appearing microcalcifications and molecular prognostic factors[J].Int J Cancer(Basel), 2002, 102(1):86-90. [34] NYANTE S J, LEE S S, BENEFIELD T S, et al.The association between mammographic calcifications and breast cancer prognostic factors in a population-based registry cohort[J].Cancer Am Cancer Soc, 2017, 123(2):219-227. [35] ROSE D P, GRACHECK P J, VONA-DAVIS L.The interactions of obesity, inflammation and insulin resistance in breast cancer[J].Cancers(Basel), 2015, 7(4):2147-2168. [36] GUTIERREZ C, SCHIFF R.HER2:biology, detection, and clinical implications[J].Arch Pathol Lab Med, 2011, 135(1):55-62. [37] FARROKH D, BOLOURSAZ S, HOMAI F.Relationship among mammographic findings with histopathologic type of breast cancer and human epidermal growth factor receptor 2(HER2) in young women[J].Electron Physician, 2017, 9(5):4300-4305. [38] WANG Y B, IKEDA D M, NARASIMHAN B, et al.Estrogen receptor-negative invasive breast cancer:Imaging features of tumors with and without human epidermal growth factor receptor type 2 overexpression[J].Radiology, 2008, 246(2):367-375. [39] ELIAS S G, ADAMS A, WISNER D J, et al.Imaging features of HER2 overexpression in breast cancer:a systematic review and meta-analysis[J].Cancer Epidemiol Biomarkers Prev, 2014, 23(8):1464-1483. [40] THURFJELL E, THURFJELL M G, LINDGREN A.Mammographic finding as predictor of survival in 1-9 mm invasive breast cancers.worse prognosis for cases presenting as calcifications alone[J].Breast Cancer Res Treat, 2001, 67(2):177-180. [41] TABAR L, CHEN H H T, YEN M F A, et al.Mammographic tumor features can predict long-term outcomes reliably in women with 1-14-mm invasive breast carcinoma-Suggestions for the reconsideration of current therapeutic practice and the TNM classification system[J].Cancer Am Cancer Soc, 2004, 101(8):1745-1759. [42] PEACOCK C, GIVEN-WILSON R, DUFFY S.Mammographic casting-type calcification associated with small screen-detected invasive breast cancers:is this a reliable prognostic indicator?[J].Clin Radiol, 2004, 59(9):855-870. [43] TSAU H S, YEN A M, FANN J C, et al.Mammographic tumour appearance and triple-negative breast cancer associated with long-term prognosis of breast cancer death:a Swedish Cohort Study[J].Cancer Epidemiol, 2015, 39(2):200-208. [44] ZHANG L N, LIU Y X, SONG F J, et al.Functional SNP in the microRNA-367 binding site in the 3' UTR of the calcium channel ryanodine receptor gene 3(RYR3) affects breast cancer risk and calcification[J].Proc Natl Acad Sci USA, 2011, 108(33):13653-13658. [45] ALRAHBI S, CHAN P M, HO B C, et al.Extent of margin involvement, lymphovascular invasion, and extensive intraductal component predict for residual disease after wide local excision for breast cancer[J].Clin Breast Cancer, 2015, 15(3):219-226. [46] HOLMBERG L, WONG Y N, TABÁR L, et al.Mammography casting-type calcification and risk of local recurrence in DCIS:analyses from a randomised study[J].Br J Cancer, 2013, 108(4):812-819. [47] 陈翱翔, 孟然, 齐晓敏, 等.乳腺钼靶伴有倾向恶性钙化的乳腺癌患者保乳术后的预后分析[J].中国肿瘤临床, 2016, 43(17):761-765. [48] RAUCH G M, HOBBS B P, KUERER H M, et al.Microcalcifications in 1657 patients with pure ductal carcinoma in situ of the breast:correlation with clinical, histopathologic, biologic features, and local recurrence[J].Ann Surg Oncol, 2016, 23(2):482-489. [49] ANDERSSON Y, FRISELL J, SYLVAN M, et al.Breast cancer survival in relation to the metastatic tumor burden in axillary lymph nodes[J].J Clin Oncol, 2010, 28(17):2868-2873. [50] FAN L, ZHENG Y, YU K D, et al.Breast cancer in a transitional society over 18 years:trends and present status in Shanghai, China[J].Breast Cancer Res Treat, 2009, 117(2):409-416. |
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