超声弹性成像在乳腺癌中的诊断价值及其与肿瘤细胞增殖凋亡基因的相关性分析  

Diagnostic value of ultrasonic elastography in breast cancer and its correlation with the proliferation and apoptosis genes of cancer cells

作　　者：李正楠 张健[2] 倪小京 LI Zhengnan;ZHANG Jian;NI Xiaojing(1Ultrasound Department;Pathology Department, People’s Hospital of Haimen, Haimen 226100, Jiangsu, China)

机构地区：[1]海门市人民医院超声科,江苏海门2261000 [2]海门市人民医院病理科,江苏海门2261000

出　　处：《癌症进展》2018年第14期1731-1733,1737,共4页Oncology Progress

摘　　要：目的探讨超声弹性成像在乳腺癌中的诊断价值及其与肿瘤细胞增殖凋亡基因的相关性。方法选取80例乳腺肿块患者的临床资料进行回顾性分析,共102个病灶;全部患者均行超声弹性成像检查,采用荧光定量聚合酶链反应(PCR)法检查良、恶性病灶中信号转导及转录激活因子3(STAT3)、存活蛋白(survivin)和B细胞淋巴瘤2(Bcl-2)基因的表达情况,并分析超声弹性成像对乳腺良、恶性病灶的诊断结果与组织病理学诊断结果的一致性。结果经组织病理学诊断后发现,102个病灶中,良性病灶41个,恶性病灶61个。超声弹性成像诊断良恶性病灶与病理组织诊断结果比较,一致性尚可(Kappa=0.461,P﹤0.05)。超声弹性成像诊断恶性病灶的灵敏度、特异度、阳性预测值和阴性预测值分别为81.97%、63.41%、76.92%和70.27%;超声弹性成像诊断良性病灶的灵敏度、特异度、阳性预测值和阴性预测值分别为63.41%、81.97%、70.27%和76.92%。恶性病灶中STAT3 mRNA、survivin mRNA和Bcl-2 m RNA的相对表达量均高于良性病灶(P﹤0.05)。Spearman秩相关分析结果显示,良恶性病灶的弹性成像评分与STAT3 m RNA、survivin mRNA和Bcl-2 mRNA的表达均呈正相关(rs=0.511、0.606、0.554,P﹤0.05)。结论超声弹性成像对乳腺癌具有较高的诊断价值,同时,超声弹性成像评分与肿瘤细胞增殖凋亡基因的表达具有一定的相关性。Objective To investigate the diagnostic value of ultrasonic elastography in breast cancer and its correlation with the proliferation and apoptosis genes of cancer cells.Method The clinical data of80patients with breast lumps with a total of102lesions were analyzed retrospectively.All patients were examined by ultrasonic elastography,and the expression of signal transduction and activator of transcription3(STAT3),survivin and B cell lymphoma2(Bcl-2)genes in the benign and malignant lesion was detected by fluorescence quantitative polymerase chain reaction(PCR).The consistency between ultrasonic elastography diagnosis of benign and malignant lesions and the histopathological diagnosis was compared.Result The histopathological results showed that among the102lesions there were41benign lesions and61malignant lesions.The consistency of ultrasonic elastography and pathology in the diagnosis of malignant lesions is acceptable(Kappa=0.461,P<0.05).The sensitivity,specificity,positive predictive value and negative predictive value of ultrasonic elastography in diagnosis of malignant lesions were81.97%,63.41%,76.92%and70.27%,respectively.The sensitivity,specificity,positive predictive value and negative predictive value of ultrasonic elastography in diagnosis of benign lesions were63.41%,81.97%,70.27%,76.92%,respectively.The relative expressions of STAT3,survivin and Bcl-2mRNA in malignant lesions were significantly higher than those in benign lesions(P<0.05).The Spearman rank correlation analysis showed positive correlation between ultrasonic elastography score and the expression of STAT3,survivin and Bcl-2mRNA(rs=0.511,0.606and0.554,P<0.05).Conclusion Ultrasonic elastography has high value in the diagnosis of breast cancer,at the same time,the elastography score has a certain correlation with the expressions of proliferation and apoptosis genes in the cancer cells.

关 键 词：超声弹性成像 乳腺癌 增殖 凋亡 基因 

分 类 号：R737.9[医药卫生—肿瘤]