乳腺癌原发灶SWE评估腋窝淋巴结转移的S100A4-胶原机制  

Investigation of S100A4-collagen mechanism of axillary lymph node metastasis in breast cancer evaluated by shear wave elastography

作　　者：温欣[1] 于玺文 田宇航[1] 刘钊[1] WEN Xin;YU Xi-wen;TIAN Yu-hang;LIU Zhao(Department of Ultrasonography,Harbin Medical University Cancer Hospital;The Office of Heilongjiang Academy of Medical Sciences,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学附属肿瘤医院超声科 [2]黑龙江省医学科学院办公室,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2020年第6期629-632,共4页Journal of Harbin Medical University

基　　金：黑龙江省卫生健康委科研课题(2019-063)。

摘　　要：目的探讨乳腺癌原发灶剪切波弹性成像(shear wave elastography,SWE)评价腋窝淋巴结转移(axillary lymph node metastasis,ALNM)的价值并探索S100A4-胶原诊断机制。方法纳入经病理证实的浸润性乳腺癌(invasive breast cancer,IBC)患者,分为ALNM组(LNM+)和无ALNM组(LNM-)。术前行SWE检查并记录最大弹性值(Emax)、平均弹性值(Emean)和弹性比值(ER);对病理切片行胶原染色和S100A4免疫组化染色,分析SWE、S100A4与胶原的相关性。结果 LNM+组原发灶SWE参数值均显著高于LNM-组(P<0.001);Emax具有最好的诊断表现;LNM+组胶原容积分数(collagen volume fraction,CVF)和S100A4积分光密度(integrated optical density,IOD)显著高于LNM-组(P<0.001);Emax、Emean、ER和IOD与CVF均呈正相关(P<0.001)。结论 IBC原发灶SWE能有效评估ALNM,S100A4-胶原是诊断机制中的关键环节。Objective To evaluate the diagnostic efficacy of shear wave elastography(SWE) on primary invasive breast cancer(IBC) for indicating axillary lymph node metastasis(ALNM) and to investigate if the association between S100 A4 and collagen plays a key role in the diagnostic mechanism. Methods The included samples were divided into LNM+ and LNM-groups depending on the presence or absence of ALNM as defined by postoperative pathology. SWE was performed on the primary IBC before biopsy and operation. The differences of the three elastic parameter values(Emax, Emean, and ER) of SWE between the two groups were compared. Sirius red and immunohistochemical staining were used to examine the collagen deposition and S100 A4 expression of included tissue samples, and correlations of SWE and S100 A4 expression with collagen deposition were analyzed. Results SWE showed that Emax, Emean and ER of IBC in the LNM+ group were significantly higher than those in the LNM-group(P<0.001). The diagnostic performance of Emax was the best. Collagen volume fraction(CVF) and the integrated optical density of S100 A4(IOD) in the LNM+ group were significantly higher than those in the LNM-group(P<0.001). Emax, Emean, EmeanR, and IOD were all positively correlated with CVF(P<0.001). Conclusion SWE in primary IBC could be used to evaluate ALNM, in which diagnostic mechanism S100 A4-collagen is a key link.

关 键 词：剪切波弹性成像 乳腺癌 腋窝淋巴结转移 S100A4 

分 类 号：R737.9[医药卫生—肿瘤]