| 摘要: |
| 目的 采用超声超微血管成像（SMI）技术探讨不同中医证型乳腺癌患者的血流特征。方法 选取2017年6月至2021年8月于黑龙江中医药大学附属第一医院就诊并经术后病理确诊的肿块型乳腺癌患者62例（恶性组）和乳腺良性肿瘤患者50例（良性组），将62例乳腺恶性肿瘤患者依据中医证型分为肝郁痰凝证组（24例）、冲任失调证组（20例）、正虚毒盛证组（18例）。手术前各组均给予常规超声和SMI检查，分析比较各组间的二维超声及其超微血流特征。结果 二维超声结果显示恶性3个证型组及良性组4组间肿块大小、微钙化、后方回声及有无淋巴结转移情况的差异均有统计学意义（P均<0.01）。良性组与恶性3个证型组比较，SMI血管数目差异有统计学意义（P<0.05）。肝郁痰凝证组SMI血管数目0级患者比例高于冲任失调证组和正虚毒盛证组，正虚毒盛证组SMI血管数目Ⅲ级患者比例高于肝郁痰凝证组和冲任失调证组、Ⅰ级患者比例低于肝郁痰凝证组和冲任失调证组，差异均有统计学意义（P均<0.05）；病理组织学分级肝郁痰凝证组Ⅰ级患者比例较高，冲任失调证组Ⅱ级患者比例较高，正虚毒盛证组Ⅲ级患者比例较高。结论 SMI可以有效判定不同中医证型乳腺癌患者超微血管特征，能够为乳腺癌中医辨证施治提供可靠依据。 |
| 关键词: 超微血管成像技术 乳腺肿瘤 中医证型 病理诊断 |
| DOI：10.16781/j.CN31-2187/R.20211106 |
| 投稿时间：2021-11-02修订日期：2022-01-19 |
| 基金项目:国家自然科学基金（81704055），黑龙江省中医药科研项目（ZHY19-002）. |
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| Blood flow characteristics of breast cancer patients with different Traditional Chinese Medicine syndromes based on superb microvascular imaging technology |
| SHI Guang-yu,ZHANG Xue-song,LI Jing,HAN Jie-ru,ZHAO Li-na* |
(Department of Ultrasound, The First Affiliated Hospital, Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, Heilongjiang, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the blood flow characteristics of breast cancer patients with different Traditional Chinese Medicine (TCM) syndromes by superb microvascular imaging (SMI). Methods A total of 62 patients with mass breast cancer (malignant group) and 50 patients with benign breast tumors (benign group), who were diagnosed by pathology in The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from Jun. 2017 to Aug. 2021, were selected. The 62 breast cancer patients were divided into liver stagnation and phlegm coagulation syndrome group (24 cases), Chong Ren disorder syndrome group (20 cases) and positive deficiency and strong toxin syndrome group (18 cases). Before operation, all groups were given routine ultrasound and SMI, and the 2-dimensional ultrasound and ultra-fine blood flow characteristics were analyzed and compared among the groups. Results The 2-dimensional ultrasound showed significant differences in nodule size, microcalcification, posterior echo and lymph node metastasis among the benign group and 3 malignant syndrome groups (all P<0.01). There was significant difference in the number of SMI blood vessels between the benign group and 3 malignant syndrome groups (all P<0.05). The proportion of patients with SMI grade 0 in the liver stagnation and phlegm coagulation syndrome group was higher than those in the other 2 syndrome groups (both P<0.05). The proportion of patients with SMI grade Ⅲ in the positive deficiency and strong toxin syndrome group was higher than those in the other 2 syndrome groups, and the proportion of patients with grade I was lower than those in the other 2 syndrome groups (all P<0.05). The histopathological classification showed that the proportions of grade I patients in the liver stagnation and phlegm coagulation syndrome group, grade Ⅱ patients in the Chong Ren disorder syndrome group and grade Ⅲ patients in the positive deficiency and strong toxin syndrome group were all higher. Conclusion SMI can effectively reveal the characteristics of ultramicrovessels of breast cancer patients with different TCM syndromes, providing reliable basis for TCM syndrome differentiation treatment. |
| Key words: superb microvascular imaging breast neoplasms Traditional Chinese Medicine syndrome pathologic diagnosis |
