乳腺癌剪切波弹性模量硬度平均值在其分子亚型及病理特征中的差异  

Difference in the mean of elasticity in shear-wave elastography among breast cancer of different molecular subtypes and pathological features

作　　者：李程[1] 梁键锋[1] 曾福强[1] 陈湘[1] Li Cheng;Liang Jianfeng;Zeng Fuqiang;Chen Xiang(Department of Ultrasound,Zhongshan Traditional Chinese Medicine Hospital,Zhongshan 528400,China)

机构地区：[1]广东省中山市中医院超声科,中山528400

出　　处：《广西医科大学学报》2020年第3期483-487,共5页Journal of Guangxi Medical University

基　　金：广东省中山市医学科研资助项目(No.2018A020116)。

摘　　要：目的:探讨乳腺癌剪切波弹性模量硬度平均值(E mean)在其分子亚型及病理特征中的差异。方法:选取经手术病理证实的98例乳腺癌患者的100个病灶作为研究对象,术前均行常规超声和剪切波弹性成像(SWE)检查,记录E mean;术后记录其组织学类型、组织学分级和腋窝淋巴结状况。根据免疫组化结果,分子亚型分为Luminal A型、Luminal B型、HER2过表达型和三阴型,并分析E mean在以上病理特征中的差异性。结果:乳腺癌的肿块大小、组织学分级及乳腺影像报告和数据系统(BI-RADS)分类在E mean方面比较,差异有统计学意义(P<0.05)。雌激素受体(ER)阴性及人类表皮生长因子受体(HER2)阳性与更高的E mean相关(P<0.05)。各亚型中,HER2过度表达型肿块最硬,三阴型肿块次之,Luminal A型肿块硬度最小(P<0.05)。结论:乳腺癌E mean随其分子亚型侵袭性增加而增加,两者存在一定相关性;SWE检查对肿块硬度的评估可为乳腺癌治疗方法的选择和预后评估提供重要的参考价值。Objective:To explore the difference in the mean of elasticity(E mean)in shear-wave elastography(SWE)among breast cancers of different molecular subtypes and pathological characteristics.Methods:100 lesions of 98 breast cancer patients confirmed by surgery and pathology were selected as the research objects.All patients underwent conventional ultrasound and SWE before surgery to record E mean,and the histological type,histological grade and axillary lymph node status were recorded after surgery.The molecular subtypes were divided into Luminal A type,Luminal B type,HER2 overexpression type and triple negative type according to the results of immunohistochemistry,and the differences of E mean in these five molecular subtypes were analyzed.Results:E mean was significant differences in the tumor size,histological grade,and breast imaging report and data system(BI-RADS)classification(P<0.05).High E mean was associated with estrogen receptor(ER)negative and human epidermal growth factor receptor(HER2)positive(P<0.05).Among all molecular subtypes,the tumor of HER2 overexpression type was the hardest,followed by triple negative type,and Luminal A type had the lowest hardness(P<0.05).Conclusion:E mean of breast cancer increases with the invasiveness of molecular subtypes,and there is a certain correlation between E mean and molecular subtypes.The evaluation of tumor hardness by SWE examination has important reference value for the choice of breast cancer treatment methods and prognosis evaluation.

关 键 词：乳腺癌 剪切波弹性成像 分子亚型 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]