雌激素受体阴性的乳腺癌患者人表皮生长因子受体2表达状态与多模态超声特征的相关性研究  

Study on the correlation between HER-2 expression status and multimode ultrasonic characteristics in ER-negative breast cancer

作　　者：魏天赐 张蕾[1] 刘瑾瑾 康佳 田家玮[1] Wei Tianci;Zhang Lei;Liu Jinjin;Kang Jia;Tian Jiawei(Department of Ultrasound,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,150086

出　　处：《中华超声影像学杂志》2019年第11期976-980,共5页Chinese Journal of Ultrasonography

基　　金：目国家自然科学基金(81271647,81630048,81701705);黑龙江省博士后资助经费(LBH-Z17174)。

摘　　要：目的探讨在雌激素受体(ER)表达阴性的乳腺癌患者中,人表皮生长因子受体2(HER-2)的表达状态与常规超声、剪切波弹性成像(SWE)及超声造影(CEUS)图像特征的相关性。方法选取2017年9月至2018年7月在哈尔滨医科大学附属第二医院就诊,有明确病理结果,且ER表达阴性患者117例,共117个病灶,HER-2阳性者62例为Ⅰ组,HER-2阴性者55例为Ⅱ组。术前均采集常规超声图像、SWE图像,62例患者采集CEUS图像,分析不同HER-2表达情况下三者超声特征的差异性。结果①常规超声:Ⅰ组多表现为形状不规则,边界不清晰,并以边缘毛刺为主,内部可见微钙化,易出现腋窝淋巴结转移,且更容易在较高的组织学分级检出;Ⅱ组则无上述特点(均P<0.05);②SWE:Ⅰ组较Ⅱ组杨氏模量的最大值、平均值及病变组织与脂肪组织硬度比值均高(均P<0.05);③CEUS:Ⅰ组较Ⅱ组达峰时间提前,上升支斜率及曲线下面积更大,且更容易观察到穿支血管征,而Ⅱ组更易出现充盈缺损(均P<0.05)。结论ER表达阴性时,不同乳腺癌HER-2表达状况下,其多模态声像图表现有明显差异性,分析上述声像图特征将对临床治疗方案的选择具有重要的指导作用。Objective To explore the correlation between the expression status of human epidermal growth factor receptor 2(HER-2)and the characteristics of conventional ultrasound,shear wave elastography(SWE)and contrast enhanced ultrasound(CEUS)images in breast cancer patients with negative expression of estrogen receptor(ER).Methods In this study,117 patients with 117 lesions were selected from the Second Hospital of Harbin Medical University Hospital,who had definite pathology and ER negative expression,including 62 patients with positive HER-2(groupⅠ)and 55 patients with negative HER-2(groupⅡ).Conventional ultrasound images and SWE were collected preoperatively,and CEUS images were collected in 62 patients to analyze the correlation between the expression of HER-2 and the ultrasonic characteristics of the three ultrasonic modes.Results①Conventional ultrasound:the groupⅠwas characterized by irregular shape,unclear boundary,mainly with spicule edges,microcalcification,axillary lymph node metastasis and higher histological grading.The groupⅡhad no such characteristics(all P<0.05).②SWE:the Emax,Emean and Eratio of groupⅠwere higher than groupⅡ(all P<0.05).③CEUS:the peak time of groupⅠwas earlier than groupⅡ,the slope of ascending branch and the area under the curve were larger,and the characteristics of perforating vessels were easier to be observed,while perfusion defects were more likely to occur in groupⅡ(all P<0.05).Conclusions In the case of ER negative expression,there are obvious differences in multimodal sonograms of different breast cancer HER-2 expression conditions.The analysis of the above sonograms will play an important guiding role in the selection of clinical treatment plans.

关 键 词：超声检查 乳腺肿瘤 剪切波弹性成像 超声造影 人表皮生长因子受体2 

分 类 号：R73[医药卫生—肿瘤]