乳腺癌对比增强能谱乳腺X线摄影与免疫组化标记物的相关性研究  

Correlation between contrast-enhanced spectral mammography and immunohistochemical markers in breast cancer

作　　者：李鸿恩 谭健彬 李悦龙 吕培锋 彭经纶 曾益辉 LI Hong-en;TAN Jian-bin;LI Yue-long;LV Pei-feng;PENG Jing-lun;ZENG Yi-hui(Department of Radiology,Guangdong Women’s and Children’s Hospital,Guangdong 511000,China)

机构地区：[1]广东省妇幼保健院放射科,广东广州511000

出　　处：《影像诊断与介入放射学》2022年第6期434-439,共6页Diagnostic Imaging & Interventional Radiology

摘　　要：目的研究对比增强能谱乳腺X线摄影(CESM)形态学特征在免疫组化标记物阳性与阴性之间的差异性,分析其临床意义。方法回顾性分析病理诊断乳腺癌患者88例,均行CESM检查及免疫组化标记物检测[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)及细胞增殖抗原标记物(Ki-67)],分析乳腺癌患者CESM病灶形态学特征大小、边缘、形态、微钙化、强化程度,将CESM形态学特征与免疫组化标记物进行相关性分析。结果88例乳腺癌患者中浸润性癌64例,导管内原位癌10例,浸润性癌伴导管内原位癌10例,浸润性癌伴乳头状癌2例,导管内癌伴乳头状癌2例。免疫组化标记物ER、PR、HER-2、Ki-67在乳腺癌患者中阳性率分别为61.36%、50.00%、70.45%、84.09%。肿瘤大小与Ki-67阳性表达有关(P=0.003);形态与PR、HER-2阳性表达有关(P=0.031、0.001);微钙化与Ki-67阳性表达有关(P=0.009);“毛刺征”与ER阳性表达有关(P=0.020);强化程度与HER-2、Ki-67阳性表达有关(P=0.014、0.030)。结论乳腺癌CESM形态学特征与免疫组化标记物之间存在一定的相关性。CESM形态学特征在乳腺癌诊治及预后评估方面具有较大的参考价值。Objective To study the difference between the positive and negative immunohistochemical markers in the morphological features of contrast-enhanced spectral mammography(CESM),and analyze its clinical significance.Methods 88 patients with pathologically confirmed breast cancer underwent CESM and immunohistochemical marker detection including estrogen receptor(ER),progesterone receptor(PR),human epidermis growth factor receptor-2(HER-2)and cell proliferation antigen markers(Ki-67).The morphological features of lesions on CESM including the size,margin,morphology,microcalcification,and degree of contrast enhancement were retrospectively analyzed.Correlation analysis with immunohistochemical markers was performed.Results The 88 lesions were invasive carcinoma(64),intraductal carcinoma-in-situ(10),invasive carcinoma with intraductal carcinoma-in-situ(10),invasive carcinoma with papillary carcinoma(2),and intraductal carcinoma with papillary carcinoma(2).The positive rates of immunohistochemical markers were 61.36%ER+,50.00%PR+,70.45%HER-2+,and 84.09%Ki-67+.There was significant correlation between tumor size and Ki-67 positive expression(P=0.003);morphology and PR(P=0.031)and HER-2(P=0.001)positive expressions;microcalcification and Ki-67 positive expression(P=0.009);“burr sign”and ER positive expression(P=0.020);the degree of enhancement and HER-2(P=0.014)and Ki-67(P=0.030)positive expression.Conclusion Morphological characteristics of CESM correlate with immunohistochemical markers and are valuable in the diagnosis,treatment and prognosis assessment of breast cancer.

关 键 词：对比增强能谱乳腺X线摄影 形态学特征 乳腺癌 免疫组化标记物 

分 类 号：R814.41[医药卫生—影像医学与核医学] R737.9[医药卫生—放射医学]