雌激素受体阴性乳腺癌HER-2过表达及与影像学和临床病理特征的关系  

The relationship of imaging and clinicopathologic feature of tumors with human epidermal growth factor receptor type 2 overexpression in estrogen receptor-negative breast carcinomas

作　　者：马少君[1] 刘延梅[2] 张月浪[3] 康晓丽[1] 梁晓燕[1] 周理乾[1] 李文生[4] Ma Shaojun Liu Yanmei Zhang Yuelang Kang Xiaoli Liang Xiaoyan Zhou Liqian Li Wensheng(Department of Radiology The Second Endemic Area of the West Department 4 Department of Pathology, Shaanxi People ＂s Hospital, Shaanxi Xi ＇an 710068, Chin 3 Department of Radiology, the First Affiliated Hospital of Xi＇an Jiaotong University, Shaanxi Xi ＇an 710061, China)

机构地区：[1]陕西省人民医院放射科,陕西西安710068 [2]陕西省人民医院西院二病区,陕西西安710068 [3]西安交通大学第一附属医院放射科,陕西西安710061 [4]陕西省人民医院病理科,陕西西安710068

出　　处：《现代肿瘤医学》2016年第23期3725-3729,共5页Journal of Modern Oncology

基　　金：陕西社发科技攻关项目(编号:2016SF-168);陕西科学技术研究发展计划项目(编号:2013K-12-03-19)

摘　　要：目的:探讨人类表皮生长因子受体HER-2过表达在雌激素受体阴性(ER^-)乳腺癌诊断中的价值及其与钼靶、超声影像学特征及临床病理特征的关系,并与ER-/HER-2^-乳腺癌进行比较。方法:收集临床资料完整的ER-乳腺癌患者190例,其中HER-2过表达(HER-2^+)乳腺癌患者78例,HER-2无过表达(HER-2^-)型乳腺癌患者112例。比较两组患者的钼靶及超声影像学表现和临床病理特征。结果:在这190例ER-乳腺癌患者中,HER-2^+乳腺癌组与HER-2^-组比较,年龄差异具有统计学意义(P=0.004 9);均具有较高的病理组织学分级,组间差异无统计学意义(P=0.296)。HER-2^+乳腺癌组更多表现为淋巴结阳性(P=0.003)。钼靶X线检查HER-2^+与HER-2^-两组间比较,差异具有统计学意义(P<0.001)。单纯钙化HER-2^+组(46.2%)较HER-2^-组(13.4%),差异具有统计学意义(P<0.001);单纯肿物HER-2^-组(58.0%)较HER-2^+组(34.6%),差异具有统计学意义(P=0.003 8);肿物特征HER-2^+组与HER-2^-组比较,差异具有统计学意义(P=0.017);HER-2^+组(42.5%)多表现为分叶状肿物,较HER-2^-组(14.9%),差异具统计学意义(P=0.003 0);HER-2^-组(33.3%)多为圆形肿物,较HER-2^+组(12.5%),差异具有统计学意义(P=0.013);HER-2^+组与HER-2^-组肿物边缘组间比较,差异具有统计学意义(P<0.001);HER-2^+组(57.5%)较多变现为毛刺,较HER-2^-组(14.9%),差异具有统计学意义(P<0.001);HER-2^-组较HER-2^+组光滑程度,差异具有统计学意义(P<0.001);HER-2^+组(89.8%)更多表现为恶性钙化,较HER-2^-组(29.7%),差异具有统计学意义。超声检查HER-2^+组与HER-2^-组,差异具有统计学意义(P<0.005);肿块边缘差异具有统计学意义(P<0.001);内部回声差异具有统计学意义(P=0.014)。结论:不同类型的乳腺癌有不同的生物学特征,其钼靶影像学表现也不尽相同,了解ER-HER-2^+型乳腺癌的钼靶及超声影像学特征,可帮助临床医师预测乳腺癌这一亚型及相关类型和患者的预后,以及评估Objective： To determine if estrogen receptor（ ER）- negative human epidermal growth factor receptor type 2（ HER- 2）- positive and ER- negative HER- 2- negative breast cancers have distinguishing clinical and imaging features. Methods： 190 cases of ER- negative breast cancer included in this study. There were 78 cases of HER-2 overexpression（ HER- 2＋） breast cancer,112 cases without HER- 2 overexpression（ HER- 2-） breast cancer.Their pathological and mammographic data were analyzed. The pathological and mammographic features of the two groups were compared. Results： Without HER- 2 overexpression（ HER- 2-） with ER- negative breast cancer group and HER- 2 overexpression（ HER- 2＋） with ER- negative breast cancer group all had a higher histological grade,but no significant difference（ P = 0. 296）. Compared with the without HER- 2 overexpression（ HER- 2-） breast cancer group,frequency of HER- 2 / neu overexpression in each age group was evaluated and significant differences.HER- 2 overexpression（ HER- 2＋） breast cancer group was more likely to have a lymphonodus positive（ P =0. 003）,mammographic imaging appearances and were correlated with tumor HER- 2 status（ P 0. 001）. Compared with the without HER- 2 overexpression（ HER- 2-） breast cancer group,the HER- 2 /neu overexpression（ HER-2＋） breast cancer group more likely represented simple calcification（ 46. 2% vs 13. 4%,P 0. 001）. Compared with the HER- 2 overexpression（ HER- 2＋） breast cancer group the without HER- 2 overexpression（ HER- 2-） breast cancer group more likely represented a simple mass（ 58. 0% vs 34. 6%,P = 0. 003 8）. The characteristics of mass shape were correlated with tumor HER- 2 status（ P = 0. 017）. HER- 2 without overexpression（ HER- 2-） breast cancer more likely shows round shape（ 33. 3% vs 12. 5%,P = 0. 013）,the HER- 2 overexpression（ HER- 2＋）breast cancer more likely shows lobulated shape（ 42. 5% vs 14. 9%,P = 0. 003 0）. Moreover,the tumor mass

关 键 词：乳腺肿瘤 雌激素受体 表皮生长因子受体 过表达 钼靶摄影 超声 

分 类 号：R737.9[医药卫生—肿瘤]