超声造影对伴原位癌的乳腺癌病灶范围的评估价值及影响因素  

Value and influencing factors of contrast-enhanced ultrasound in the evaluation of the range of carcinoma in situ breast cancer lesions

作　　者：热西达·加帕尔[1] 冷晓玲[1] 耿怡[1] REXIDA·Jiapaer;LENG Xiao-ling;GENG Yi(Tumor Hospital Affiliated to Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学附属肿瘤医院,新疆乌鲁木齐830011

出　　处：《中国临床医学影像杂志》2020年第12期875-878,882,共5页Journal of China Clinic Medical Imaging

基　　金：国家自然科学基金,项目编号:81660496。

摘　　要：目的:分析超声造影对伴原位癌的乳腺癌病灶范围的评估价值及影响因素.方法:选择自2016年1月—2019年1月于我院行手术治疗的138例伴原位癌的乳腺癌患者作为研究对象,术前均行二维超声和超声造影检查,以术后病理标本测值为金标准,比较两种影像测值与术后病理标本测值的差值、一致性检验结果及相关性,采用单因素方差分析临床病理学因素对超声造影测值准确性的影响并进行多因素Logistic回归分析.结果:超声造影测值与术后病理标本测值的差值为(0.20±0.15)cm,明显小于二维超声与术后病理标本测值的差值((0.55±0.33)cm),差异有统计学意义(P<0.05);超声造影测值与术后病理标本测值的一致率为66.67%,明显高于二维超声与术后病理标本测值的一致率(13.77%),差异有统计学意义(P<0.05);经Pearson相关性分析,超声造影测值与术后病理标本测值的相关系数r为0.91,明显大于二维超声与术后病理标本测值的相关系数(r=0.83),差异有统计学意义(P<0.05);准确组与不准确组在年龄、组织学分级、腺体类型、增强方式和VEGF、ER、PR、HER2表达上差异均有统计学意义(P<0.05);经多因素Logistic回归分析,VEGF、HER2阳性表达及ER、PR阴性表达均是影响超声造影测值准确性的独立危险因素(P<0.05).结论:超声造影对伴原位癌的乳腺癌病灶范围的评估价值较好,而测值准确性受VEGF、HER2阳性表达及ER、PR阴性表达影响.Objective:To evaluate the diagnostic value and impact factors of contrast-enhanced ultrasonography in the range of carcinoma in situ breast cancer lesions.Methods:A total of 138 patients with in situ breast cancer lesions were enrolled,who underwent surgery in our hospital from January 2016 to January 2019.Two-dimensional ultrasound and contrast-enhanced ultrasound were performed before surgery.The postoperative pathological findings were treated as gold standard.Comparison analyses of the two ultrasound measurements and the postoperative pathological findings were performed.The consistency test and the correlation analyses were also performed.One-way analysis of variance and multivariate logistic regression analysis were used to analyze the influence of clinicopathological factors on the accuracy of contrast-enhanced ultrasound.Results:The range difference of carcinoma was(0.20±0.15)cm between the contrast-enhanced ultrasonographic measurements and postoperative pathological findings,which was significantly less than(0.55±0.33)cm between two-dimensional ultrasounic measurements and postoperative pathological findings(P<0.05).The consistency between contrast-enhanced ultrasonographic measurements and postoperative pathological findings was 66.67%,which was significantly higher than 13.77% between two-dimensional ultrasounic measurements and postoperative pathological findings(P<0.05).The correlation coefficient r between the contrast-enhanced ultrasonographic measurements and postoperative pathological findings was 0.91,which was significantly greater than 0.83 between two-dimensional ultrasounic measurements and postoperative pathological findings(P<0.05).There were significant differences in age,histological grade,gland type,enhancement pattern and VEGF,ER,PR,HER2 expression between the accurate group and the inaccurate group(P<0.05).Especially,the positive expression of VEGF and HER2 and the negative expression of ER and PR were independent impact factors for the accuracy of contrast-enhanced ultrasounograph

关 键 词：乳腺肿瘤 癌 原位 超声检查 

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