三阴性乳腺癌的超声图像特征及其与P53、BRCA1蛋白表达的相关性  

Ultrasonographic features of triple negative breast cancer and its relationship with the expression of P53 and BRCA1

作　　者：陈功泉 石琳 胡卯秀 刘宇 秦琼 CHEN Gongquan;SHI Lin;HU Maoxiu;LIU Yu;QIN Qiong(Department of Ultrasound Imaging,Minda Hospital Affiliated to Hubei University for Nationalities,Hubei 445000,China)

机构地区：[1]湖北民族大学附属民大医院超声影像科,湖北省恩施市445000 [2]湖北民族大学附属民大医院妇产科,湖北省恩施市445000

出　　处：《临床超声医学杂志》2021年第6期406-409,共4页Journal of Clinical Ultrasound in Medicine

基　　金：湖北省卫生计生委科研立项项目(WJ2017MB355)。

摘　　要：目的探讨三阴性乳腺癌(TNBC)的超声图像特征,分析其与P53、BRCA1蛋白表达的相关性。方法将168例乳腺癌患者根据孕激素受体、雌激素受体、人表皮生长因子受体-2的不同表达,分为TNBC组61例和非TNBC组107例。两组均于术前1周行超声检查,观察肿瘤边界、形态、内部钙化、后方回声、病灶大小等情况,彩色多普勒观察病灶内部及周围血流情况。术后行免疫组化检测P53、BRCA1蛋白表达情况,分析TNBC患者P53、BRCA1蛋白表达与超声特征的相关性。应用Logistic回归分析TNBC患者P53、BRCA1阳性表达的影响因素。结果TNBC组病灶边缘毛刺、微钙化比例、BRCA1阳性表达比例均低于非TNBC组,TNBC组病灶富血供、P53阳性表达比例均高于非TNBC组,差异均有统计学意义(均P<0.05)。P53阳性者后方回声增强比例和富血供比例均高于阴性者,BRCA1阳性者后方回声增强比例和富血供比例均低于阴性者,差异均有统计学意义(均P<0.05)。Logistic回归分析显示,血流分级是TNBC患者P53、BRCA1阳性表达的影响因素(OR=2.958、0.321,均P<0.05)。结论TNBC患者的超声图像特征表现为毛刺征、微钙化较少,以富血供为主,P53阳性表达较多,BRCA1阳性表达较少;且P53和BRCA1阳性表达均与血流分级有关。Objective To investigate the ultrasonographic features of triple negative breast cancer(TNBC),and to analyze its relationship with P53 and BRCA1 protein.Methods A retrospective selection of 168 breast cancer patients,according to the expression of progesterone receptor,estrogen receptor,human epidermal growth factor receptor-2,they were divided into TNBC group with 61 cases and non-TNBC group with 107 cases.Ultrasonography was performed 1 week before the operation to observe the tumor border,morphology,internal calcification,posterior echo,and lesion size.Color Doppler was used to observe the blood flow around and inside the lesion.The expression of P53 and BRCA1 protein were detected by immunohistochemistry after operation,and the relationship between the expression of P53 and BRCA1 protein and ultrasonographic features in TNBC patients was analyzed.Logistic regression analysis of the influencing factors of the positive expression of P53 and BRCA1 in TNBC patients was performed.Results The proportions of edge burrs,microcalcifications and positive expression of BRCA1 in the TNBC group were lower than those in the non-TNBC group(all P<0.05).The proportions of rich blood supply and positive expression of P53 in the TNBC group were higher than those in the non-TNBC group(all P<0.05).The proportions of posterior echo enhancement and rich blood supply in P53 positive patients were higher than those in negative patients,while the proportions of posterior echo enhancement and rich blood supply in BRCA1 positive patients were lower than those in negative patients,the differences were statistically significant(all P<0.05).Logistic regression analysis showed that blood flow classification was an influencing factor for the positive expression of P53 and BRCA1 in TNBC patients(OR=2.958,0.321,both P<0.05).Conclusion The ultrasonographic features of TNBC patients are characterized by a few glitches and microcalcifications.The blood flow grade of P53 and BRCA1 are mainly rich blood supply and the majority of these patients hav

关 键 词：超声检查 乳腺肿瘤 恶性 三阴性 BRCA1蛋白 P53蛋白 

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]