非特殊型浸润性乳腺癌超声征象与分子生物学指标关系分析  

Correlation of the ultrasonographic features with molecular biological indicators of nonspecific invasive breast carcinoma

作　　者：陈燕[1] 张江宇[2] 王丽敏[1] 杨超[1] 徐玲[1] 赵贤哲 CHEN Yan;ZHANG Jiang - yu;WANG Li - min;YANG Chao;XU Lin;ZHAO Xian- zhe(Department of Ultrasound,Guangdong Women and Children Hospital,Guangzhou 510010,Guangdong,China)

机构地区：[1]广东省妇幼保健院超声诊断科,广东广州510010 [2]广东省妇幼保健院病理科,广东广州510010

出　　处：《广东医学》2019年第11期1579-1583,共5页Guangdong Medical Journal

基　　金：广东省医学科学技术研究基金项目(编号:A2016528)

摘　　要：目的探讨非特殊型浸润性乳腺癌超声征象与分子生物学指标的相关性。方法回顾性分析521例经手术病理证实为非特殊型浸润性乳腺癌患者的术前乳腺超声征象,术后标本经免疫组化检测雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(HER-2)、Ki-67的表达水平,研究分析两者的相关性。结果肿瘤的形态、肿块后方回声衰减与ER、PR、HER-2及Ki-67无相关性(P>0.05)。肿块大小组中,ER、PR、HER-2及Ki-67阳性表达率差异均有统计学意义(P<0.05);边缘毛刺征组中,ER、PR的阳性表达率高于无此征象者(P<0.05);肿瘤的生长方向组中,ER、PR阳性表达率差异均有统计学意义(P<0.05);微钙化的出现与HER-2的阳性表达率有关(P<0.05);肿块丰富的血流分布与Ki-67的阳性表达率相关(P<0.05)。结论非特殊型浸润性乳腺癌超声征象与分子生物学指标间存在一定的相关性,有边缘毛刺征的乳腺癌ER、PR有更高的阳性表达率,适合内分泌治疗,预后较好;ER、PR阳性表达率高的乳腺癌更多见于平行生长,肿块纵横比<1;有微钙化的乳腺癌HER-2的阳性表达率和血流丰富的乳腺癌Ki-67的阳性表达率都更高,提示肿瘤的恶性程度高,预后不良。Objective To investigate the correlation of the ultrasonographic features with molecular biological in- dicators of nonspecific invasive breast carcinoma.Methods The preoperative ultrasonographic features of 521 patients with nonspecific invasive breast carcinoma confirmed by surgery and pathology were retrospectively analyzed.The expres- sion levels of ER,PR, HER - 2 and Ki - 67 were assessed by immunohistochemistry after operation,and the correlations between them was studied.Results There was no correlation between the shape,posterior shadow of tumor and the ex- pression of ER,PR,HER - 2 and Ki - 67 ( P > 0. 05).The positive expression rates of ER,PR,HER - 2 and Ki - 67 in the groups according to sizes were significantly different ( P < 0. 05).In the group with edge spiculated sign,the posi- tive expression rates of ER and PR were significantly higher than those without the sign ( P < 0. 05).The positive rates of ER and PR among the groups according to growth direction were significantly different ( P < 0. 05).The occurrence of mi- crocalcification was significantly correlated to the positive expression rate of HER - 2 ( P < 0. 05),and the abundant blood flow distribution was significantly correlated to the positive expression rate of Ki - 67 ( P < 0. 05).Conclusion Ultra- sound signs of nonspecific invasive breast carcinoma are correlated with molecular biological indicators.Breast carcinoma with edge spiculated sign has higher positive expression rate of ER and PR,which is suitable for endocrine therapy and has better prognosis.Breast carcinoma with higher positive expression rate of ER and PR is more common in parallel growth, aspect ratio < 1.The positive expression rate of HER - 2 is correlated with microcalcification,and Ki - 67 is correlated with abundant blood flow,suggesting more malignant and poorer prognosis.

关 键 词：乳腺癌 超声 雌激素受体 孕激素受体 人类表皮生长因子受体2 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]