乳腺癌多模态超声特征与HCK、MRPL13表达的相关性研究  

Correlation study of multimodal ultrasound characteristics with HCK and MRPL13 expression in breast cancer

作　　者：杜云芳 周余旺[2] 方昀 童文静[2] 周红梅 Du Yunfang;Zhou Yuwang;Fang Yun;Tong Wenjing;Zhou Hongmei(Department of Ultrasound,Quzhou City Hospital of Traditional Chinese Medicine,Zhejiang 324000;Department of Ultrasound,Quzhou City People’s Hospital,Zhejiang 324000,China)

机构地区：[1]衢州市中医医院超声科,浙江324000 [2]衢州市人民医院超声科,浙江324000

出　　处：《中华内分泌外科杂志》2021年第2期134-140,共7页Chinese Journal of Endocrine Surgery

基　　金：浙江省科技学技术厅项目(2018GSA90017)。

摘　　要：目的本研究旨在探讨乳腺癌多模态超声特征与造血细胞激酶(hematopoietic cell kinase,HCK)和线粒体核糖体蛋白L13(mitochondrial ribosomal protein L13,MRPL13)表达水平的相关性。方法选择2017年1月至2020年9月于衢州市人民医院就诊并行手术治疗的204例女性乳腺癌患者作为研究对象,术中取乳腺癌组织和癌旁正常组织。术前行常规超声、剪切波弹性成像(shear wave elastography,SWE)和超声造影(contrast-enhanced ultrasonography,CEUS)检查,采用免疫组织化学法检测HCK和MRPL13的表达水平。使用单因素分析和二元Logistic回归分析多模态超声特征和HCK、MRPL13的相关性。结果乳腺癌组织中的HCK和MRPL 13阳性表达比例均显著高于癌旁组织(χ^(2)=5.625、7.197;P=0.018、0.007)。常规超声特征中,HCK阳性乳腺癌患者中出现肿块边缘不规整、微钙化和II~III级血流分级的比例显著高于HCK阴性患者(χ^(2)=7.437、16.684、23.262;P=0.006、<0.001、<0.001);MRPL13阳性乳腺癌患者中出现肿块最大径≥2 cm、肿块边缘不规整和II~III级血流分级的比例显著高于MRPL13阴性者(χ^(2)=4.676、11.118、8.389;P=0.031、0.001、0.004)。对于SWE征象,HCK阳性乳腺癌患者出现硬环征的比例显著高于HCK阴性者(χ^(2)=11.220,P=0.001);MRPL13阳性乳腺癌患者出现硬环征和黑洞征的比例均显著高于MRPL13阴性者(χ^(2)=4.482、8.775;P=0.034、0.003)。CEUS特征中,HCK阳性患者出现高增强的比例显著高于HCK阴性者(χ^(2)=7.356,P=0.007);MRPL13阳性患者出现高增强和晚消退的比例显著高于MRPL13阴性者(χ^(2)=9.165、7.631;P=0.002、0.006)。二元Logistic分析结果表明,出现微钙化(OR=4.619,95%CI=2.657~8.119,P=0.009)、血流分级II~III级(OR=4.150,95%CI=2.547~7.954,P=0.015)和CEUS表现高增强(OR=4.150,95%CI=2.547~7.954,P=0.015)是HCK阳性表达的独立危险因素;血流分级II~III级(OR=4.213,95%CI=3.145~8.557,P=0.012)、出现黑洞征(OR=5.246,95%CI=2.864~10.378,P<0.001)�Objective To investigate the correlation between hematopoietic cell kinase(HCK)and the expression level of the mitochondrial ribosomal protein L13(MRPL13)and hematopoietic multimode ultrasound.Methods 204 female breast cancer patients treated by surgery in Quzhou people’s Hospital from Jan.2017 to Sep.2020 were selected as study subjects.Breast cancer tissues and adjacent normal tissues were extracted intraoperatively.Preoperative conventional ultrasound,shear wave elastography(SWE)and contrast-enhanced Ultrasonography(CEUS)were used to detect HCK and MRPL13 expression levels.Univariate analysis and binary Logistic regression were used to analyze the correlation between multi-mode ultrasonic features and HCK and MRPL13.Results The positive expression ratios of HCK and MRPL 13 in breast cancer tissues were significantly higher than those in adjacent tissues(χ^(2) was 5.625,7.197;P was 0.018,0.007).In conventional ultrasound features,the proportions of HCK-positive breast cancer patients with irregular mass edges,microcalcifications,and grade II to III blood flow classification were significantly higher than those of HCK-negative patients(χ^(2) was 7.437,16.684,23.262;P was 0.006,<0.001,<0.001);The proportion of MRPL13-positive breast cancer patients with a maximum diameter of≥2 cm,irregular edges of the tumor,and grade II-III blood flow classification was significantly higher than that of MRPL13-negative patients(χ^(2) was 4.676,11.118,8.389;P was 0.031,0.001,0.004).For SWE signs,the proportion of HCK positive breast cancer patients with hard ring sign was significantly higher than that of HCK negative patients(χ^(2)=11.220,P=0.001);the proportion of MRPL13 positive breast cancer patients with hard ring sign and black hole sign was significantly higher than that of MRPL13.Those who were negative(χ2 was 4.482,8.775;P was 0.034,0.003).Among CEUS characteristics,the proportion of HCK-positive patients with high enhancement was significantly higher than that of HCK-negative patients(χ^(2)=7.356,P=0.007);the

关 键 词：乳腺癌 超声 剪切波弹性成像 超声造影 造血细胞激酶 线粒体核糖体蛋白L13 

分 类 号：R655.8[医药卫生—外科学] R737.9[医药卫生—临床医学]