乳腺癌人类表皮生长因子受体2表达与X线表现的相关性分析  

Correlation between human epidermal growth factor receptor type 2 status in breast cancer and mammographic features

作　　者：刘小庆[1] 林青[2] 崔春晓[1] 段峰[1] 赵继平[1] 

机构地区：[1]青岛大学医学院附属医院放射科,山东青岛266100 [2]青岛大学医学院附属医院乳腺病诊疗中心,放射科,山东青岛266100

出　　处：《医学影像学杂志》2013年第5期795-798,802,共5页Journal of Medical Imaging

基　　金：青岛市公共领域科技支撑计划项目(项目编号:2012-1-3-2-(8)-NSH)

摘　　要：目的对比分析人类表皮生长因子受体2(HER-2)阳性和阴性乳腺癌X线特征,探讨乳腺癌X线征象与HER-2基因之间的相关性。方法回顾性分析经手术病理确诊的812例女性乳腺癌患者的X线表现,根据免疫组织化学结果分为HER-2阳性组(235例)和HER-2阴性组(577例)。对比分析两组乳腺癌肿块和钙化的X线特征,肿块主要分析形态、边界及边缘,钙化主要分析形状及分布形式,并对各项分析结果进行检验,P<0.05为差异性有统计学意义。结果 HER-2阳性组乳腺癌较阴性组多表现为钙化(2=37.560,P=0.001),HER-2阴性组乳腺癌X线表现多为单纯肿块(2=37.560,P=0.001)。星芒状肿块在HER-2阴性组比例较高(2=5.912,P=0.015),两组类圆形(P=0.480)、分叶状(P=0.111)、不规则形肿块(P=0.150)分布比例则无明显统计学差异。HER-2阳性组乳腺癌肿块边界多模糊不清(2=8.319,P=0.004),阴性组肿块边界多为部分清楚(2=5.818,P=0.016)。HER-2阳性组乳腺癌钙化形态多表现为沙砾状(2=8.955,P=0.003)、多形性和不定形(2=7.137,P=0.008),分布形式无明显统计学差异。结论 HER-2阳性乳腺癌X线表现钙化居多,且多为沙砾状、多形性和不定形钙化,肿块边界多模糊不清;HER-2阴性乳腺癌多表现为单纯肿块,边界多为部分清楚,星芒状肿块多见。Objective To prospectively determine relationships between human epidermal growth factor receptor type 2 （HER2） status in breast cancer and mammographic imaging features by use of comparatively analyzed mammograms of patients with HER2-positive and HER2-negative breast cancer. Methods Pre-operative mammographic data of 812 women with breast cancer, who underwent breast surgical biopsy and certified by pathology, were retrospectively reviewed. 235 HER2-positive patients and 577 HER2-negative patients were divided according to immunohistochemical reports. Mammographic imagings of both of breast cancers included simple mass, simple microcalcification, mass associated microcalcification. We mainly analyzed shapes, margins of masses and appearances, distribution of microcalcifications. All data were analyzed with the Chi-square test, P〉0.05 indicated a significant difference. Results HER2-positive breast cancers were more likely than HER2-negative cancers to have microcalcifications （X2 = 37. 560, P=0. 001）, but simple masses were less （X2= 37. 560, P = 0. 001）. HER2-negative breast cancers were more likely than HER2-positive cancers to have stellate masses （X2=5. 912, P =0. 015）, but other mass shapesuch as round, lobular, irregular masses, were not associated with HER2 status. HER2-positive breast cancers were more likely to appear as indistinct masses （X2= 8. 319, P = 0. 004）, while HER2-negative tumors were more likely to appear as partly clear masses （X2 =5. 818, P =0. 016）. Compared with HER2-negative breast cancers, HER2-positive cancers were more likely to appear as grave-like microealcifications （X2 = 8.955, P = 0. 003）, pleomorphic and amorphous microcalcifications （X2 = 7.137, P = 0. 008）, but microcalcifications distribution of all breast cancers were not associated with HER2 status. Conclusion HER2-positive breast cancer usually shows microcalcifications and indistinct mass in mammography; moreover, grave-like, pleomophic and amorphous microcalcifications are more likely

关 键 词：乳腺肿瘤 乳房X线摄影术 受体 erbB-2 对比研究 

分 类 号：R737.9[医药卫生—肿瘤] R814.3[医药卫生—临床医学]