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目的 探讨女性年龄、月经状态与乳腺纤维腺体组织密度的相关性.方法 回顾性分析2015年10月至2016年8月天津医科大学肿瘤医院行乳腺X线摄影检查,未绝经者月经周期为28~30 d或已自然绝经1年以上,至少一侧乳腺无病变的1734例受试者.同期纳入行乳腺X线摄影检查,行子宫切除术后或乳腺癌术后使用化疗药物的139例患者作为非自然绝经组.应用计算机辅助检测系统自动计算获得每个受试者的乳腺纤维腺体组织密度.1734例受试者按年龄分为4组,分别为≤35岁组(n=217)、36~45岁组(n=533)、46~55岁组(n=491)和≥56岁组(n=493);按月经状态分为未绝经组(n=1015)和自然绝经组(n=719),未绝经组又分为经中(n=158)、经后1周(n=311)、经后2周(n=316)、经前1周(n=230)4个亚组.非自然绝经组根据绝经原因分为子宫切除组(n=62)和乳腺癌术后使用化疗药物的药物绝经组(n=77).采用Pearson相关性检验评价年龄与乳腺纤维腺体组织密度的相关性.采用单因素方差分析比较不同年龄组受试者间、不同月经状态组受试者间组织密度的差异,采用独立样本t检验比较未绝经组与自然绝经组、非自然绝经组与自然绝经组乳腺纤维腺体组织密度的差异.结果 不同年龄受试者间的组织密度差异有统计学意义,其中≥56岁组的组织密度低于其他各组(P<0.05).年龄与乳腺纤维腺体组织密度呈中度负相关(r=-0.456,P<0.01).未绝经组和自然绝经组乳腺纤维腺体组织密度分别为(20.11±8.54)%、(11.30±6.05)%,差异有统计学意义(t=25.138,P<0.05).不同月经状态受试者的乳腺纤维腺体组织密度差异有统计学意义,其中经后1周亚组与经前1周亚组的差异有统计学意义(P<0.05).139例非自然绝经的患者中,子宫切除组、药物绝经组的腺体组织密度分别为(16.27±6.91)%和(15.44±7.31)%,两组腺体组织密度差异有统计学意义(t=-5.592,P<0.05).结论 乳腺纤维腺体组织密度随年龄的增长而降低,未绝经女性乳腺纤维腺体组织密度明显高于绝经女性,经后1周乳腺纤维腺体组织密度低于经前1周.

Objective To investigate the correlation between female age,menstrual status and the density of breast fibrous glandular tissue. Methods A total of 1 734 subjects with mammography examination were retrospectively analyzed,who were with 28 to 30 d menstrual cycle,or underwent natural menopause for more than 1 years,or with at least one side of the breast had no lesions,from October 2015 to August 2016 in Medical University Of Tianjin Cancer Hospital. At the same time, another 139 cases with mammography examination were treated as nonnatural menopause group, who received hysterectomy or postoperative chemotherapy of breast cancer. The breast fibrous gland tissue density of each subject was automatically calculated by the computer aided diagnosis system. One thousand seven hundred and thirty four subjects were divided into 4 groups according to age,including≤35 years old group(n=217),36 to 45 years old group(n=533),46 to 55 years old group(n=491),≥56 years old group(n=493),and was divided into premenopausal group(n=1 015)and natural postmenopausal group(n=719)according to the menstrual status.The premenopausal group was further divided into four subgroups:menstruation(n=158),one week after menstruation(n=311),two weeks after menstruation(n=316),and one week before menstruation(n=230). According to the status of menopause, the nonnatural postmenopausal group was divided into hysterectomy group(n=62)and drug menopause group(n=77)because of the postoperative chemotherapy of breast cancer. Pearson method was used to evaluate the correlation between age and breast fibrous glandular tissue density.A single factor analysis of variance was used to compare the differences in tissue density of subjects from different age groups and subjects from different menstrual status groups. The independent sample t test was used to compare the difference of the breast fibrous glandular tissue density between the premenopausal group and the natural postmenopausal group and between the nonnatural menopause group and the natural postmenopausal group.Results The tissue density differences of subjects from different age groups were statistically significant, and the tissue density of ≥56 years old group was lower compared to the other groups(P<0.05).A moderately negative correlation was presented between age and breast fibrous glandular tissue density(r=-0.456,P<0.01).The breast fibrous glandular tissue density of the premenopausal group was higher than that of natural postmenopausal group [(20.11 ± 8.54)% vs. (11.30±6.05)%,t=25.138,P<0.05].As to the different menstrual status,there was a significant differences between one week after menstruation subgroup and one week before menstruation subgroup(P<0.05).The density of fibrous glandular tissues in the hysterectomy group and the drug menopause group was(16.27± 6.91)% and(15.44±7.31)%, respectively. There was significant difference between drug postmenopausal group and natural postmenopausal group(t=-5.592, P<0.05). Conclusions Breast fibrous glandular tissue density decreases with the age. The breast fibrous glandular tissue density of the premenopausal women is significantly higher than that of natural postmenopausal women.The breast fibrous glandular tissue density of one week after menstruation is lower than that of the one week before menstruation.