Magnētiskās rezonanses un patohistoloģiskās izvērtēšanas salīdzinošs pētījums krūts dziedzera audzēja pacientēm
Date
2021
Authors
Āboliņš, Juris
Journal Title
Journal ISSN
Volume Title
Publisher
Latvijas Universitāte
Abstract
Ievads. Ar katru gadu krūts vēža incidence pieaug arī gados jaunām sievietēm. Lai diagnosticētu krūts vēzi, ir jāveic gan radioloģiskā, gan patohistoloģiskā izmeklēšana. Magnētskas rezonanses (MR) rezultāts ir atkarīgs no precīzas iegūto datu interpretācijas. Bieži vien diagnozes precizēšanai ir nepieciešama arī ārsta patologa slēdziens. Pētījuma mērķis. Noskaidrot, vai, izmantojot tikai MR krūts izmeklēšanā, ir iespējams precīzi diagnosticēt labdabīgu vai ļaundabīgu krūts veidojumu, nepielietojot biopsiju. Materiāli un metodes. Retrospektīvs šķērsgriezuma pētījums tika veikts Rīgas Austrumu Klīniskās universitātes slimnīcā. Pētījumā tika iekļautas 100 pacientes ar krūts vēzi. No Latvijas Onkoloģijas centra arhīvu datiem tika izmantoti MR apraksti par krūts dziedzeru malignitātes riska standartizēto novērtēšanas sistēmu (BI-RADS) un no Patoloģijas Centra ieguva biopsiju patohistoloģiskos slēdzienus laika posmā no 2018. līdz 2020. gadam. Pētījumā tika salīdzināta BI-RADS atrade ar patohistoloģisko slēdzienu. Datu statistiskai analīzei tika izmantots Microsoft Office Excel 2016 un IBM Statistical Package for Social Scientists (SPSS) 26.0. Rezultāti. Pētījumā tika iekļautas 100 pacientes vecumā 22 - 91 gadiem (mediānais vecums 56.50 gadi). Pēc MR slēdziena 39 pacientēm (39.0%) bija aprakstītas izmaiņas labajā krūtī, 46 (46.0%) kreisajā krūtī, bet izmaiņas abās krūtīs novēroja 15 (15%) pacientēm. Izvērtējot veidojuma anatomisko lokalizāciju, visbiežāk (73.0%) veidojums bija lokalizēts krūts dziedzerī (gl.mammae). Pēc BI-RADS labdabīgi veidojumi bija 21 pacientei (22.8%), bet ļaundabīgi 71 (77.2%). Patohistoloģiskā izmeklēšana tika veikta 88 (88.0%) pacientēm, no kurām karcinoma in situ tika pierādīta 8 (8.0%), 49 invazīva duktāla karcinoma (49.0%), invazīva lobāra karcinoma 4 (4.0%) pacientēm, bet audi ar fibrozi bija 16 pacientēm (16.0%).Tika noteikta statistiski ticama asociācija starp BI-RADS atradi un patohistoloģisko slēdzienu, un imūnhistoķīmiju-estrogēnu receptoru (ER), progestronu receptoru (PR), monoklonālo antivielu Ki-67 un cilvēka epidermālā augšanas faktora receptora 2 (HER2) ekspresiju (p < 0.001). Visiem respondentiem ar histoloģiski pierādītu ļaundabīgu veidojumu BI-RADS atrade bija ļaundabīga. Secinājumi. MR BI-RADS skala atbilst ļaundabīga krūts vēža patohistoloģiskajam aprakstam.
Introduction. The incidence of breast cancer each year is increasing among young women. To diagnose breast cancer, both radiological and pathohistological examinations must be performed. The result of magnetic resonance imaging (MRI) depends on the exact interpretation of the obtained data. Often, the conclusion of a pathologist is also necessary to clarify the diagnosis. The aim of the study. Find out wheather breast benign and malign formations can be diagnosed without biopsy using MRI breast examination only. Materials and methods. A retrospective cross-sectional study at Rigas East Clinical University hospital was performed. 100 patients with breast cancer were included. MRI descriptions of the Breast Imaging Reporting and Data System (BI-RADS) from the archives of the Latvian Oncology Centre and pathohistological conclusion from Centre of Pathology were used between 2018 and 2020. The findings of BI-RADS and pathohistological findings were compared. Microsoft Office Excel 2016 and IBM Statistical Package for Social Scientists (SPSS) 26.0 were used for data statistical analysis. Results. 100 women with age range 22-91 years (median-56.60 years) were included. Changes in the right breast were observed in 39 patients (39.0%), 46 (46.0%) in the left breast, but changes in both breasts were observed in 15 (15%) patients. 73.0% of cases the breast formation was localizated in the mammary gland (gl.mammae). According to BI-RADS, benign formations in 21 (22.8%) and malignant in 71 patients (77.2%) were observed. The pathohistological examination was performed in 88 (88.0%) patients and results were following: in 8 (8.0%) carcinoma in situ, in 49 invasive ductal carcinoma (49.0%), in 4 (4.0%) invasive lobar carcinoma while tissues with fibrosis were in 16 patients (16.0%). There were statistically significant associations between BI-RADS findings and pathohistological conclusion and immunohistochemistry- expression of estrogen receptors (ER), progeteron receptors (PR), monoclonal antibody Ki-67 and human epidermal growth factor receptor 2 (HER-2) (p < 0.001).5 The finding of BI-RADS was malignant in all respondents with histologically proven malignancies. Conclusions. MRI BI-RADS score findings are similar to pathohistological findings of breast cancer.
Introduction. The incidence of breast cancer each year is increasing among young women. To diagnose breast cancer, both radiological and pathohistological examinations must be performed. The result of magnetic resonance imaging (MRI) depends on the exact interpretation of the obtained data. Often, the conclusion of a pathologist is also necessary to clarify the diagnosis. The aim of the study. Find out wheather breast benign and malign formations can be diagnosed without biopsy using MRI breast examination only. Materials and methods. A retrospective cross-sectional study at Rigas East Clinical University hospital was performed. 100 patients with breast cancer were included. MRI descriptions of the Breast Imaging Reporting and Data System (BI-RADS) from the archives of the Latvian Oncology Centre and pathohistological conclusion from Centre of Pathology were used between 2018 and 2020. The findings of BI-RADS and pathohistological findings were compared. Microsoft Office Excel 2016 and IBM Statistical Package for Social Scientists (SPSS) 26.0 were used for data statistical analysis. Results. 100 women with age range 22-91 years (median-56.60 years) were included. Changes in the right breast were observed in 39 patients (39.0%), 46 (46.0%) in the left breast, but changes in both breasts were observed in 15 (15%) patients. 73.0% of cases the breast formation was localizated in the mammary gland (gl.mammae). According to BI-RADS, benign formations in 21 (22.8%) and malignant in 71 patients (77.2%) were observed. The pathohistological examination was performed in 88 (88.0%) patients and results were following: in 8 (8.0%) carcinoma in situ, in 49 invasive ductal carcinoma (49.0%), in 4 (4.0%) invasive lobar carcinoma while tissues with fibrosis were in 16 patients (16.0%). There were statistically significant associations between BI-RADS findings and pathohistological conclusion and immunohistochemistry- expression of estrogen receptors (ER), progeteron receptors (PR), monoclonal antibody Ki-67 and human epidermal growth factor receptor 2 (HER-2) (p < 0.001).5 The finding of BI-RADS was malignant in all respondents with histologically proven malignancies. Conclusions. MRI BI-RADS score findings are similar to pathohistological findings of breast cancer.
Description
Keywords
Medicīna , Krūts vēzis , BI-RADS , magnētiskā rezonanse , patohistoloģiskā izvērtēšana