超声造影定性特征和VueBox定量参数评估乳腺癌分子分型的应用价值  

Qualitative characteristics of contrast-enhanced ultrasound and VueBox quantitative perfusion analysis of the molecular classification of breast cancer

作　　者：苏荃利 李玲玲 邓芸霞 林菲菲 胡巧[1] Su Quanli;Li Lingling;Deng Yunxia;Lin Feifei;Hu Qiao(Department of Ultrasound,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China;Guilin Medical University,Guilin 541199,China)

机构地区：[1]广西壮族自治区人民医院超声科,南宁530021 [2]桂林医学院,桂林541199

出　　处：《中华超声影像学杂志》2023年第5期399-405,共7页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(81660292,82160339);广西自然科学基金(2020GXNSFAA259014)。

摘　　要：目的探讨超声造影定性特征及VueBox定量参数评估乳腺癌病理分子分型的应用价值。方法回顾性分析2020年1月至2022年7月于广西壮族自治区人民医院接受超声造影检查的经病理证实的乳腺癌患者133例,根据免疫组化结果分为管腔上皮(Luminal)A型、Luminal B型、人表皮生长因子2(HER-2)型、三阴性型,分析不同分子分型乳腺癌的超声造影定性特征及VueBox定量参数的差异,构建ROC曲线评价超声造影对不同分子分型乳腺癌的诊断效能。结果不同分子分型间乳腺癌增强强度、增强后边界、充盈缺损、周边放射状汇聚等特征差异有统计学意义(均P<0.05),而是否均匀性增强差异无统计学意义(P>0.05)。HER-2型与三阴性型乳腺癌的峰值强度(PE)、流入相和流出相曲线下面积(WiWoAUC)、流入相比率(WiR)大于Luminal A型和Luminal B型,差异有统计学意义(均P<0.05)。ROC曲线分析结果显示,PE、放射状汇聚诊断Luminal A型的ROC曲线下面积分别为0.849、0.780,敏感性分别为0.711、0.889,特异性分别为0.909、0.671,准确性分别为0.842、0.744;PE诊断Luminal B型的曲线下面积为0.852,敏感性、特异性、准确性分别为0.825、0.763、0.782;WiWoAUC、充盈缺损诊断HER-2型的效能较高,曲线下面积分别为0.912、0.898,敏感性分别为0.903、0.903,特异性分别为0.853、0.892,准确性分别为0.865、0.895;增强后边界清晰诊断三阴性型的曲线下面积为0.919,敏感性、特异性、准确性分别为0.941、0.897、0.902。结论不同分子分型乳腺癌的超声造影定性特征及VueBox定量参数存在一定差异,可为术前预测乳腺癌分子分型提供参考。Objective To investigate the value of qualitative characteristics of contrast-enhanced ultrasound(CEUS)and VueBox quantitative parameters in the evaluation of pathological molecular typing of breast cancer.Methods A retrospective analysis was performed on 133 patients with pathologically confirmed breast cancer who underwent CEUS examination in the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2020 to July 2022.The patients were divided into Luminal A type,Luminal B type,human epidermal growth factor receptor-2(HER-2)type and triple negative type according to the results of immunohistochemistry.The differences of qualitative characteristics and quantitative parameters of CEUS in different molecular subtypes of breast cancer were analyzed.The ROC curve was used to evaluate the diagnostic efficacy of CEUS in the differentiation of molecular subtypes of breast cancer.Results There were significant differences in enhancement intensity,post-enhancement boundary,filling defect and peripheral radial convergence among different molecular subtypes of breast cancer(all P<0.05),while there was no significant difference in enhancement uniformity(P>0.05).Peak enhancement(PE),wash-in and wash-out areas under the curve(WiWoAUC),and wash-in ratio(WiR)of HER-2 type and triple-negative type breast cancer were higher than Luminal A type and Luminal B type(all P<0.05).ROC curve analysis showed that PE and radial convergence had reasonable diagnostic efficiency in Luminal A type,and the areas under the curve were 0.849 and 0.780,sensitivity was 0.711 and 0.889,specificity was 0.909 and 0.671,accuracy was 0.842 and 0.744,respectively.The areas under the curve of PE in diagnosing Luminal B type was 0.852,the sensitivity,specificity,and accuracy were 0.825,0.763 and 0.782,respectively.The area under the curve of WiWoAUC and filling defect in diagnosing HER-2 type were 0.912 and 0.898,the sensitivity was 0.903 and 0.903,the specificity was 0.853 and 0.892,and the accuracy was 0.865 and 0.895,respectively.The area u

关 键 词：超声造影 乳腺癌 分子分型 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]