联合超声、MRI及钼靶评估HER-2过表达型及三阴性乳腺癌的诊断价值研究  

Combined Diagnostic Value of Ultrasonography,MRI and Mammography in Evaluating HER-2 Overexpression and Triple-negative Breast Cancer

作　　者：刘晓瑜[1,2] 林翠君 黄洁[1] 罗欢嘉 代海洋 LIU Xiaoyu;LIN Cuijun;HUANG Jie(Shantou University Medical College,Shantou,Guangdong Province 515000,P.R.China)

机构地区：[1]汕头大学医学院,汕头515000 [2]惠州市中心人民医院超声医学科,516001 [3]惠州市中心人民医院放射科,516001

出　　处：《临床放射学杂志》2023年第7期1098-1102,共5页Journal of Clinical Radiology

基　　金：广东省基础与应用基础研究基金省市联合基金项目(编号:2020A1515110563);广东省医学科研基金项目(编号:B2021052)。

摘　　要：目的探讨联合超声、MRI及钼靶影像学特征评估HER-2过表达型与三阴性乳腺癌中的诊断价值。方法回顾性分析确诊的乳腺癌患者的临床及影像学资料,根据其病理及免疫组织化学结果,筛选出HER-2过表达型及三阴性乳腺癌患者共77例,分析患者的超声、MRI及钼靶的影像学特征与其他相关临床资料,并进行统计学分析。结果乳腺癌肿瘤的超声血流Alder分级、肿瘤MRI强化特征及钼靶发现的肿瘤内钙化在HER-2过表达型乳腺癌及三阴性乳腺癌中差异有统计学意义(P<0.05)。乳腺癌肿瘤的超声血流Alder分级及肿瘤MRI强化特征是HER-2过表达型与三阴性乳腺癌的独立预测因子(OR=0.423~3.051,P<0.05),ROC曲线下面积为0.730。HER-2过表达型乳腺癌肿瘤内血流Alder分级主要为Ⅱ/Ⅲ级,MRI强化特征多表现为不均匀强化,肿瘤内多伴有钙化。三阴性乳腺癌肿瘤内血流Alder分级主要为0/Ⅰ级,MRI强化特征以环形强化为主,肿瘤内多不伴有钙化。乳腺癌患者的年龄、绝经情况、淋巴结转移情况及乳腺癌肿瘤的大小、形态、边缘、纵横比、内部回声、后方回声、MRI乳腺实质背景强化、动态增强曲线、DWI扩散情况、乳腺腺体量等影像学特征在HER-2过表达型乳腺癌及三阴性乳腺癌中差异无统计学意义(P>0.05)。结论联合分析超声、MRI及钼靶影像学特征对评估HER-2过表达型及三阴性乳腺癌具有一定的诊断价值。Objective To investigate the combined diagnostic value of ultrasonography,MRI and mammography in evaluating the HER-2 overexpression and triple-negative breast cancer.Methods A cohort of 77 patients confirmed of breast cancer were retrospectively analyzed.According to the results of pathology and immunohistochemistry,patients were grouped into HER-2 overexpression breast cancer and triple-negative breast cancer.The imaging features extracted from ultrasonography,MRI and mammography as well as relevant clinical factors were recorded and statistically analyzed.Results The Alder grade of ultrasonography,the enhancement pattern of MRI and calcification in mammography have statistically difference in HER-2 overexpression and triple-negative breast cancer(P<0.05).Only the Alder grade of ultrasonography and the enhancement pattern of MRI remained the independent risk factors as confirmed by multinomial Logistic regression analysis(OR=0.423-3.051,P<0.05),further ROC curve showed the area under curve was 0.730.The Alder grade was mainlyⅡ/Ⅲin HER-2 overexpression breast cancer.The MRI enhancement pattern was mostly heterogeneous enhancement and accompanied by calcification in HER-2 overexpression breast cancer.The Alder grade was mainly 0/Ⅰand the MRI enhancement pattern was mostly rim enhancement and no calcification in triple-negative cancer.There was no statistically difference in terms of age,menopause,lymph node metastasis and the size,shape,margin,aspect ratio internal echo,posterior echo,background enhancement of breast parenchyma,dynamic contrast enhanced curves,DWI value and breast gland volume between HER-2 overexpression and triple-negative breast cancer(P>0.05).Conclusion The combined analysis of ultrasonography,MRI and mammography has diagnostic value in evaluating HER-2 overexpression and triple-negative breast cancer.

关 键 词：超声 磁共振成像 钼靶 乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]