不同分子亚型乳腺癌患者超声表现及病理学特征的对比研究  

Comparison of ultrasonic imaging and pathological characteristics in breast cancer patients with different molecular subtypes

作　　者：李英[1] LI Ying(Department of Ultrasound Medicine,Zigong Fourth People’s Hospital,Sichuan 643000,China)

机构地区：[1]四川省自贡市第四人民医院超声医学科,643000

出　　处：《临床超声医学杂志》2023年第2期131-136,共6页Journal of Clinical Ultrasound in Medicine

摘　　要：目的分析并比较不同分子亚型乳腺癌患者的超声表现及病理学特征。方法回顾性分析我院经手术病理证实的130例乳腺癌患者,根据免疫组织化学检测结果将其分为管腔A型(Luminal A型)38例、管腔B型(Luminal B型)41例、三阴型29例及人类表皮生长因子受体2(HER-2)过表达型22例(HER-2过表达型);比较不同分子亚型患者的超声表现及病理学特征,分析病理学特征及超声表现与不同分子亚型乳腺癌的关系。结果不同分子亚型患者在肿瘤边界、回声类型、后方回声、形态、钙化、血流信号方面比较差异均有统计学意义(均P<0.05);其中Luminal A、B型超声多表现为毛刺状(76.32%、73.17%)、低回声(97.37%、92.68%)、后方回声无变化(52.63%、60.98%)、无钙化(73.68%、65.85%)、形态不规则(57.89%、58.54%)、0~Ⅰ级血流信号(71.05%、70.73%);三阴型超声多表现为微分叶(72.41%)、低回声(75.86%)、后方回声增强(55.17%)、形态不规则(75.86%)、无钙化(72.41%)及0~Ⅰ级血流信号(68.97%);HER-2过表达型超声多表现为边界清晰(50.00%)、低回声(81.82%)、后方回声增强(68.18%)、形态不规则(86.36%)、有钙化(68.18%)及Ⅱ~Ⅲ级血流信号(77.27%)。不同分子亚型患者在组织学分级、淋巴结转移情况及肿瘤直径比较差异均有统计学意义(均P<0.05),其中Luminal A、B型组织学分级多表现为Ⅰ、Ⅱ级(50.00%、51.22%)、淋巴结未见转移(57.89%、68.29%)、肿瘤直径<2 cm(57.89%、56.10%);三阴型组织学分级多表现为Ⅰ、Ⅱ级(31.03%、44.83%)、淋巴结有转移(51.72%)、肿瘤直径≥2 cm(55.17%);HER-2过表达型多表现为Ⅲ级(72.73%)、淋巴结有转移(52.73%)、肿瘤直径≥2 cm(77.27%)。Ⅰ、Ⅱ、Ⅲ级乳腺癌患者在血流信号及形态方面比较差异均有统计学意义(均P<0.05)。结论不同分子亚型乳腺癌患者均有其典型的超声表现及病理学特征,临床可根据其影像特征判断乳腺癌患者的分子亚型,为�Objective To analyze and compare the ultrasonic imaging and pathological characteristics in breast cancer patients with different molecular subtypes.Methods A total of 130 patients with breast cancer confirmed by pathology in our hospital were retrospectively analyzed.According to the results of immunohistochemistry,they were divided into luminal type A(Luminal A,n=38),luminal type B(Luminal B,n=41),triple-negative type(n=29)and proto-oncogene human epidermal growth factor receptor 2(HER-2)overexpression type(HER-2 overexpression,n=22).The ultrasonic imaging and pathological characteristics were recorded and compared.The relationship between pathological characteristics,ultrasonic imaging characteristics and breast cancer with different molecular subtypes were analyzed.Results There were significant differences in tumor boundary,echo types,posterior echo,morphology,calcification and blood flow grading among patients with different molecular subtypes(all P<0.05).The main ultrasonic imaging characteristics in Luminal A and B type showed spicule sign(76.32%,73.17%),low echo(97.37%,92.68%),no change of posterior echo(52.63%,60.98%),no calcification(73.68%,65.85%),irregular morphology(57.89%,58.54%)and grade 0~Ⅰblood flow(71.05%,70.73%).The main ultrasonic imaging characteristics in triple-negative type showed micro-lobulation sign(72.41%),low echo(75.86%),posterior echo enhancement(55.17%),irregular morphology(75.86%),no calcification(72.41%)and grade 0~Ⅰblood flow(68.97%).The main ultrasonic imaging characteristics in HER-2 overexpression type showed clear boundary(50.00%),low echo(81.82%),posterior echo enhancement(68.18%),irregular morphology(86.36%),calcification(68.18%)and gradeⅡ~Ⅲblood flow(77.27%).There were significant differences in histological grading,lymph node metastasis and tumor diameter among patients with different molecular subtypes(all P<0.05).The main characteristics in Luminal A or B type showed histological grading ofⅠ,Ⅱ(50.00%,51.22%),lymph node non-metastasis(57.89%,68.29%)and tumo

关 键 词：超声检查 乳腺肿瘤 恶性 分子亚型 影像特征 病理学特征 

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]