摘要
目的通过使用倾向性评分匹配来评估MRI检查对乳腺浸润性小叶癌患者治疗方法的影响,研究术前乳腺MRI成像与浸润性小叶癌(invasive lobular carcinoma,ILC)患者手术结果之间的关系。方法回顾性分析2006年1月至2016年12月,北京市中西医结合医院及北京市上地医院接受手术治疗的210例ILC患者。61.9%的患者(130/210)接受了MRI检查。统计乳腺X线摄影和超声检查未检出病灶的MR检出率,并分析了患者的治疗过程。在倾向性评分匹配后,1∶1匹配患者34例,患者的基本特征及肿瘤特征等14种变量在接受术前MRI成像的患者(MRI组)和未接受术前MRI成像的患者(对照组)的差异性趋近一致。比较手术结果。结果在MRI组130例患者中,34.6%的患者(45/130)发现了隐匿病变;62.2%的患者(28/45)存在恶性病变。24.6%的患者(32/130)由于术前MRI检查,手术方案发生了变化,91.1%(41/45)的手术结果符合病理。在倾向性评分匹配分析中,乳腺MR成像与较低的再次手术发生率相关,其优势比(Odd Ratio,OR)为0.135,P<0.05。首次乳房切除术(OR=0.736,P=0.663)和最终乳房切除术(OR=0.691,P=0.141)相似,与术前乳腺MRI成像结果间未存在统计学相关。结论术前MRI检查可用于检测隐匿的恶性肿瘤,并可显著降低重复手术的发生率,且不会增加ILC患者的乳房切除率。
Objective To evaluate the effect of magnetic resonance imaging(MRI)examination on the treatment of patients with breast invasive lobular carcinoma(ILC)by using propensity score matching,and to study the relationship between preoperative breast MRI and the surgical outcomes of ILC patients. Methods The clinical and imaging data of 210 patients with ILC who underwent surgery from January 2006 to December 2016 were retrospectively analyzed who had been admitted to Beijing Hospital of Integrated Traditional Chinese and Western Medicine and Beijing Shangdi Hospital.61.9% of patients(130/210)underwent MRI examination.The MR detection rate of undetected lesions in mammography and ultrasonography was calculated and the patients′ treatment processes were analyzed.After the propensity scores matching,34 patients with 1 ∶1 matched ratio,the differences among 14 basic characteristics and tumor characteristics in patients undergoing preoperative MRI(MRI group)and patients without preoperative MRI(control group)became consistent.Then the surgical results were compared. Results Of the 130 patients in the MRI group,34.6%(45/130)had occult lesions;62.2%(28/45)had malignant lesions.In 24.6% of patients(32/130),the surgical plan changed due to preoperative MRI examination,and 91.1%(41/45)of the results were consistent with pathology.In the propensity score matching analysis,breast MRI was associated with a lower incidence of re-operation,with an odds ratio(OR)of 0.135, P <0.05.The first mastectomy( OR =0.736, P =0.663)was similar to the final mastectomy( OR =0.691, P =0.141)and there was no statistical correlation with preoperative breast MRI. Conclusion Preoperative MRI can be used to detect occult malignancies and significantly reduce the incidence of recurrent surgery without increasing the rate of mastectomy in patients with ILC.
作者
李占平
王海
柴秀芳
Li Zhanping;Wang Hai;Chai Xiufang(Department of Surgery,Beijing Shangdi Hospital,Beijing 100083,China;Department of Surgery,Beijing Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 100039,China;Department of Radiology,Beijing Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 100039,China)
出处
《中华消化病与影像杂志（电子版）》
2019年第1期27-31,共5页
Chinese Journal of Digestion and Medical Imageology(Electronic Edition)
关键词
浸润性小叶癌
磁共振成像
倾向性评分匹配
Invasive lobular carcinoma
Magnetic resonance imaging
Propensity score matching
