非特殊型浸润性乳腺癌患者高频超声联合免疫组化检查的临床意义  

Clinical significance of high frequency ultrasound combined with immunohistochemistry in patients with non-specific invasive breast cancer

作　　者：范慧慧[1] 吴玮[1] 邵霞[2] FAN Hui-Hui;WU Wei;SHAO Xia(Department of Ultrasound,Huzhou Central Hospital,Huzhou,Zhejiang 313099,China)

机构地区：[1]湖州市中心医院超声科,浙江湖州313099 [2]湖州市中心医院乳腺科,浙江湖州313099

出　　处：《中国妇幼保健》2022年第8期1524-1528,共5页Maternal and Child Health Care of China

基　　金：浙江省科技计划基金资助项目(2018C37089)。

摘　　要：目的 探究高频超声联合雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(Her-2)及细胞核增值抗原(Ki-67)表达在诊断、评估非特殊型浸润性乳腺癌病情发展中的临床应用。方法 回顾性分析2018年8月—2019年10月在湖州市中心医院进行高频超声检查的137例非特殊型浸润性乳腺癌患者的病历资料。所有患者均接受术前高频超声检查和免疫组化检查,观察分析其高频超声表现与ER、PR、Her-2及Ki-67表达的关系。结果 137例非特殊型浸润性乳腺癌患者的ER、PR、Her-2及Ki-67的阳性表达率分别为75.18%、61.31%、37.23%及78.83%。肿块直径>2 cm、纵横比>1及肿块边界有毛刺征患者的ER、PR阳性率均明显低于肿块直径≤2 cm、纵横比≤1及肿块边界无毛刺征者,肿块直径>2 cm、血流信号分级Ⅱ~Ⅲ级患者的Her-2阳性率均明显高于肿块直径≤2 cm和血流信号分级0~Ⅰ级者,肿块直径>2 cm、肿块内部有微钙化及血流信号分级Ⅱ~Ⅲ级患者的Ki-67阳性率均明显高于肿块直径≤2 cm、肿块内部无微钙化者及血流信号分级0~Ⅰ级者,差异均有统计学意义(均P<0.05)。非特殊型浸润性乳腺癌患者的ER、PR表达与肿块直径、纵横比及肿块边缘毛刺征呈负相关关系,Her-2表达与肿块直径、肿块内部微钙化及血流信号分级呈正相关关系,Ki-67表达与肿块直径、血流信号分级呈正相关关系。结论 高频超声图像特征与非特殊型浸润性乳腺癌患者的ER、PR、Her-2及Ki-67阳性表达存在一定相关性,二者联合能够对其病情发展进行初步评估,对其个性化诊治和预后评估均具有重要价值。Objective To research the clinical application of high frequency ultrasound combined with the expression of high frequency ultrasound(ER), progesterone receptor(PR), human epidermalgrowth factor receptor 2(Her-2), nuclear value added antigen(Ki-67) in the diagnosis and evaluation of the development of nonspecific invasive breast cancer. Methods The medical records of 137 patients with nonspecific invasive breast cancer who were examined by high-frequency ultrasound in Huzhou Central Hospital from August 2018 to October 2019 were analyzed retrospectively. All patients were examined by high-frequency ultrasound before operation and immunohistochemistry. The relationships between high-frequency ultrasound and the expression of ER, PR, Her-2 and Ki-67 were observed and analyzed. Results The positive expression rates of ER, PR, HER-2 and Ki-67 in 137 patients with non-specific invasive breast cancer were respectively 75.18%, 61.31%, 37.23% and 78.83%. The ER and PR positive rates of tumor diameter >2 cm, aspect ratio >1 and tumor border with burr sign were significantly lower than those of tumor diameter ≤2 cm, aspect ratio ≤1 and tumor border without hairy thorn sign. The positive rates of HER-2 in tumor diameter >2 cm, blood flow signal grade Ⅱ-Ⅲ were significantly higher than those in tumor diameter ≤2 cm and blood flow signal grade 0-Ⅰ, respectively. The positive rates of Ki-67 in tumor diameter >2 cm, microcalcification in tumor interior, blood flow signal grade Ⅱ-Ⅲ were significantly higher than those in tumor diameter ≤2 cm, no microcalcification in tumor interior and blood flow signal grade 0-Ⅰ, the difference was statistically significant(all P<0.05). The expression of ER and PR in nonspecific invasive breast cancer was negatively correlated with tumor diameter, aspect ratio and tumor margin burr sign. The expression of HER-2 was positively correlated with tumor diameter, microcalcification and blood flow signal grading. The expression of Ki-67 was positively correlated with tumor diameter

关 键 词：非特殊型浸润性乳腺癌 高频超声 雌激素受体 孕激素受体 人类表皮生长因子受体2 细胞核增值抗原 

分 类 号：R737.9[医药卫生—肿瘤]