免疫组化指标及超声特征在乳腺导管原位癌与浸润性导管癌中的差异性研究  

Differential study of immunohistochemical parameters and ultrasonographic features in ductal carcinoma in situ and invasive ductal carcinoma of the breast

作　　者：桑田 田凤[2] 王子静[1] 曹玉文[3] 吴芳[1] 刘文[1] 王甲嘉 董建 李军[1] SANG Tian;TIAN Feng;WANG Zijing;CAO Yuwen;WU Fang;LIU Wen;WANG Jiajia;DONG Jian;LI Jun(Department of Ultrasound the First Affiliated Hospital of Medical College of Shihezi University,Shihezi,Xinjiang 832008;Department of Neurology,the First Affiliated Hospital,School of Medicine,Shihezi University,Shihezi,Xinjiang 832008,China;Department of Pathology,School of Medicine,Shihezi University,Shihezi,Xinjiang 832008,China)

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]石河子大学医学院第一附属医院神经内科,新疆石河子832008 [3]石河子大学医学院病理教研室,新疆石河子830000

出　　处：《石河子大学学报（自然科学版）》2021年第6期771-776,共6页Journal of Shihezi University(Natural Science)

基　　金：国家自然科学基金项目(82060318,81860498,81560433);新疆兵团科技攻关项目(2019DB012)

摘　　要：目的探讨免疫组化指标及超声特征在乳腺导管原位癌与浸润性导管癌中的差异性。方法回顾性收集147例(导管原位癌63例,浸润性导管癌84例)乳腺癌肿块的临床资料,记录肿块的免疫组化指标(ER、PR、HER-2、Ki-67)及常规超声特征(肿块最大径、位置、纵横比、内部回声、后方回声、毛刺征、钙化、Alder血流分级)、剪切波速度值(SWV_(max)、SWV_(ratio)、SWV_(mean)),对比分析两类乳腺癌免疫组化指标及超声特征的差异性,并初步探讨超声特征与免疫组化指标的相关性。结果与乳腺导管原位癌相比,病灶后方回声衰减或消失、血流分级Ⅱ-Ⅲ级及边缘毛刺征均多见于浸润性导管癌(χ^(2)=4.166、7.622、32.002,均P<0.05),ER、HER-2的阳性率及SWV_(max)在浸润性导管癌与导管原位癌组中的差异具有统计学意义(χ^(2)=3.901、21.828,t=4.399,均P<0.05)。结论免疫组化指标及超声特征在乳腺导管原位癌与浸润性导管癌中的表达情况具有一定的差异性,可为乳腺癌的诊断及治疗提供一定的参考依据。Objective To investigate the differences of immunohistochemical and ultrasonographic features between ductal carcinoma in situ and invasive ductal carcinoma of the breast.Methods Clinical data of 147 cases(63 cases of ductal carcinoma in situ and 84 cases of invasive ductal carcinoma)with breast cancer masses were retrospectively collected.Immunohistochemical indexes(ER,PR,HER-2,Ki-67),routine ultrasound characteristics(maximum diameter,location,aspect ratio,internal echo,posterior echo,burr sign,calcification,Alder blood flow grade)and shear wave velocity values(SWV_(max)、SWV_(ratio)、SWV_(mean))were recorded.The differences of the immunohistochemical indexes and ultrasonic characteristics of the two types of breast cancer were compared and analyzed,and the correlation between the ultrasonic characteristics and immunohistochemical indexes was preliminarily discussed.Results Compared with ductal carcinoma in situ,attenuation or absence of posterior echo,blood flow gradeⅡ-fractional grade,and marginal burr sign were more common in invasive ductal carcinoma(χ^(2)=4.166,7.622,32.002,P<0.05),the positive rate of ER,HER-2 and SWV_(max ) were significantly different between the invasive ductal carcinoma and ductal carcinoma in situ group(χ^(2)=3.901,21.828,t=4.399,P<0.05).Conclusion The expression of immunohistochemical indexes and ultrasonographic characteristics in ductal carcinoma in situ and invasive ductal carcinoma of the breast are different to some extent,which can provide certain reference for the diagnosis and treatment of breast cancer.

关 键 词：乳腺导管原位癌 乳腺浸润性导管癌 免疫组化 超声检查 弹性成像 

分 类 号：R737.9[医药卫生—肿瘤]