乳腺浸润性导管癌超声BI-RADS分类与雌、孕激素受体及CerbB-2表达的相关性  

Correlation of Ultrasound BI-RADS Categories with ER,PR and CerB-2 Expression of Breast Invasive Ductal Carcinoma

作　　者：刘军杰[1] 陈圆圆[1] 李智贤[1] 曾健[2] 韦康来[3] 王斯达[1] 

机构地区：[1]广西医科大学第一附属医院超声科,广西南宁530021 [2]广西医科大学第一附属医院胃肠腺体外科,广西南宁530021 [3]广西医科大学第一附属医院病理科,广西南宁530021

出　　处：《中国医学影像学杂志》2014年第4期244-248,共5页Chinese Journal of Medical Imaging

基　　金：国家自然科学基金项目(81160280)

摘　　要：目的分析乳腺浸润性导管癌(IDC)的超声征象,探讨其乳腺影像报告和数据系统(BI-RADS)分类与雌激素受体(ER)、孕激素受体(PR)及原癌基因CerbB-2表达的相关性。资料与方法分析323例经手术病理证实的IDC的超声表现,包括肿块大小、边缘毛刺征、纵横比、微钙化、肿块后方回声衰减、肿块内部血流、弹性评分及BI-RADS分类,术后行免疫组化检测ER、PR、CerbB-2表达,分析BI-RADS分类与ER、PR、CerbB-2表达的相关性。结果①边缘有毛刺征的IDC肿块ER、PR阳性表达率明显高于边缘无毛刺征者(χ2=7.618、6.178,P<0.05),有微钙化的IDC肿块CerbB-2阳性表达率高于无微钙化者(χ2=4.827,P<0.05),血流分级II^III级的IDC肿块CerbB-2阳性表达率高于0~I级者(χ2=4.07,P<0.05);②ER、PR、CerbB-2表达阳性的IDC的BI-RADS分类明显高于ER、PR、CerbB-2阴性者(P<0.05)。结论边缘毛刺征、微钙化、血供丰富与乳腺浸润性导管癌的分子生物学特性有一定的相关性,临床工作中有可能将ER、PR、CerbB-2阴性乳腺癌的BI-RADS分类低判。Purpose To analyze the ultrasonographic features of breast invasive ductal carcinoma （IDC）, and to explore its correlation with breast imaging reporting and data system （BI-RADS） categories and estrogen receptor （ER）, progestone receptor （PR） and proto-oncogene CerbB-2 expression. Materials and Methods Ultrasound features of 323 cases of pathologically confirmed IDC cases were analyzed, including tumor size, margin spiculation, ratio of tumor length to width, microcalcification, echo shadow, internal flow, elasticity and B1-RADS categories, while ER, PR and CerbB-2 expression was detected by postoperative immunohistochemical tests, correlations between BI- RADS categories and ER, PR, CerbB-2 expression were analyzed. Results ① ER and PR positive expression rate of IDC masses with edge burr syndrome was significantly higher than those without the syndrome （χ2=7.618 and 6.178, P〈0.05）, positive expression rate of CerbB-2 in IDC masses with micro calcification was higher than those without it （χ2=4.827. P〈0.05）, positive expression rate of CerbB-2 in IDC masses with flow grade of Ⅱ-Ⅲ was higher than those with grade 0-1 （χ2=4.07, P〈0.05）. ② BI-RADS categories of IDC with positive expression of ER, PR, CerbB-2 was significantly higher than the ER, PR, CerbB-2 negative group （P〈0.05）. Conclusion There is a certain correlation between the edge burring, micro calcification, abundant blood supply of breast IDC and its molecular biology characteristics, thus BI-RADS categories of ER, PR, CerbB-2 negative IDC may be lower estimated in the clinical work.

关 键 词：癌  导管  乳腺 超声检查 乳房 乳腺影像报告和数据系统 受体 雌激素 受体  孕酮 基因  ERBB-2 病理学  外科 

分 类 号：R737.9[医药卫生—肿瘤] R730.41[医药卫生—临床医学]