剪切波弹性参数与乳腺癌免疫组化表达的相关性  

Correlation between shear wave elastic parameters and immunohistochemical expression of breast cancer

作　　者：曹春莉 李军[1] 童瑾[1] 曹玉文[2] 董建 杜婷婷[1] CAO Chunli;LI Jun;TONG Jin;CAO Yuwen;DONG Jian;DU Tingting(Department of Ultrasonics,the First Affiliated Hospital of Medical College of Shihezi University,Shihezi 832008,China;不详)

机构地区：[1]石河子大学医学院第一附属医院超声科,新疆石河子832008 [2]石河子大学医学院病理教研室,新疆石河子830000

出　　处：《实用医学杂志》2020年第16期2244-2248,2254,共6页The Journal of Practical Medicine

基　　金：国家自然科学基金(编号:81560433);兵团科技攻关项目(编号:2019DB012)。

摘　　要：目的探讨剪切波弹性参数与乳腺癌肿块大小、年龄、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表达及分子分型的相关性。方法选择经手术病理证实的乳腺癌患者110例(共114个肿块),术前行常规超声和声触诊组织量化成像(VTIQ)技术检查,经常规超声获得肿块的大小,经VTIQ技术获得SWV最大值(SWVmax)。术后根据病理结果获得肿块免疫组化指标(ER、PR、HER-2、Ki-67)的表达情况,根据免疫组化表达情况判断肿块的分子分型。分析比较乳腺癌SWVmax值在肿块大小、患者年龄、免疫组化指标(ER、PR、HER-2、Ki-67)的表达及分子分型情况间的差异,最后将上述有差异的变量进行多因素线性回归分析,评估对SWVmax值影响的因素。结果(1)SWVmax值与癌灶大小呈正相关、与患者年龄不相关;(2)乳腺癌肿块SWVmax值在HER-2阳性表达组与阴性表达组、Ki-67高表达组与低表达组之间比较差异有统计学意义;(3)乳腺癌肿块SWVmax值在不同分子亚型间比较差异有统计学意义,不同分子分型SWVmax值排序为:Luminal B型(HER-2阳性型)、HER-2过表达型>Luminal B型(HER-2阴性型)、TNBC型>Luminal A型;(4)多因素线性回归分析结果显示:肿块大小、Ki-67表达、HER-2表达对SWVmax有影响(标准化回归系数分别为:0.496、0.258、0.213,均P<0.05)。结论剪切波弹性成像参数SWVmax值与一些乳腺癌预后相关的免疫组化指标的表达具有相关性,可以在一定程度上作为无创性反映乳腺癌生物学特征的影像学指标,因此术前使用VTIQ技术可以为乳腺癌治疗策略的选择及预后的判断提供一定的参考依据。Objective To investigate the correlation between shear wave elastic parameters and breast cancer size,age,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(HER-2),Ki-67 and molecular types.Methods 110 cases(114 masses)of breast cancer confirmed by pathology were selected.Conventional ultrasound and VTIQ were performed before operation.The size of the masses was obtained by regular ultrasound,and the maximum value of SWV(SWVmax)was obtained by VTIQ.The expression of ER,PR,HER-2,Ki-67,and molecular types were obtained according to the pathological results.The SWVmax values of breast cancer masses were analyzed and compared among tumor size,patient age,ER,PR,HER-2,Ki-67 expression and molecular type.The above-mentioned different variables were included in multiple linear regression analysis to evaluate the factors affecting the SWVmax value.Results(1)The SWVmax value was positively correlated with the size of the masses,the SWVmax value was not related to the patient’s age;(2)There was a significant difference in SWVmax of breast cancer masses between HER-2 positive expression group and negative expression group,Ki-67 high expression group and low expression group;(3)There was a significant difference in SWVmax of breast cancer masses between different molecular types.The SWVmax values of different molecular subtypes are ranked as:Luminal B type(HER-2^+),HER-2 overexpression type>Luminal B type(HER-2^-),TNBC type>Luminal A type;(4)In the multivariate linear regression analysis showed that the mass size,Ki-67 expression,and HER-2 expression had the greatest impact on the SWV max value(the standardized regression coefficients were:0.496,0.258,0.213,P<0.05).Conclusion SWVmax is related to the expression of some immunohistochemical indexes related to the prognosis of breast cancer.It can be used as a noninvasive imaging index to reflect the biological characteristics of breast cancer to a certain extent.Therefore,the use of VTIQ technology before operation may provide some refere

关 键 词：乳腺癌 弹性成像 剪切波速度 免疫组化 

分 类 号：R737.9[医药卫生—肿瘤]