对比增强能谱乳腺X线摄影征象与不同分子亚型乳腺癌的相关性  

Correlation between contrast-enhanced spectral mammography signs and different molecular subtypes of breast cancer

作　　者：李鸿恩 谢汉民 吕培锋 林兴[1] 曾益辉 张嫣[1] LI Hongen;XIE Hanmin;LYU Peifeng;LIN Xing;ZENG Yihui;ZHANG Yan(Department of Radiology,Guangdong Province Hospital for Women and Children Healthcare,Guangdong Guangzhou 511442,China)

机构地区：[1]广东省妇幼保健院放射科,广东广州511442

出　　处：《现代肿瘤医学》2023年第21期4008-4014,共7页Journal of Modern Oncology

基　　金：广东省广州市科技计划项目(编号:202002030217)。

摘　　要：目的:探讨对比增强能谱乳腺X线摄影(contrast-enhanced spectral mammography,CESM)征象与乳腺癌不同分子亚型的相关性。方法:回顾性分析我院病理诊断乳腺癌患者44例,均行CESM检查及免疫组化标志物检测雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人类表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)及细胞增殖抗原标志物(Ki-67),根据免疫组化结果将乳腺癌患者分为Luminal A、Luminal B、HER-2过表达型和三阴性型。将CESM形态学特征年龄、肿块大小、形态、微钙化、“毛刺征”、强化程度、强化密度与分子亚型进行相关性分析。结果:44例乳腺癌患者,其中浸润性癌32例,导管内原位癌5例,浸润性癌伴导管内原位癌5例,浸润性癌伴乳头状癌1例,导管内癌伴乳头状癌1例。Luminal A、Luminal B、HER-2过表达型、三阴性型分别为10例(22.73%)、17例(38.64%)、10例(22.73%)、7例(15.90%)。不同分子亚型乳腺癌与CESM影像征象在年龄、肿块大小、形态、微钙化、“毛刺征”、强化程度及强化密度方面差异无统计学意义(P>0.05)。两两比较:微钙化方面Luminal A与Luminal B型两者差异有统计学意义(P<0.05);强化密度方面Luminal B型与三阴性型差异具有统计学意义(P<0.05)。结论:乳腺癌CESM形态学特征可部分预测乳腺癌分子亚型,在指导乳腺癌诊治及预后评估方面具有参考价值。Objective:To explore the correlation between the imaging of contrast-enhanced spectral mammography(CESM)and different molecular subtypes of breast cancer.Method:44 cases of breast cancer patients diagnosed by pathology in our hospital was retrospectively analysed.All underwent CESM examination and immunohistochemical marker detection estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(HER-2)and cell proliferation antigen markers(Ki-67).According to the results of immunohistochemistry,breast cancer patients were divided into Luminal A,Luminal B,HER-2 overexpression type and triple negative type.The correlation analysis between the age,tumor size,morphology,microcalcification,spicule sign enhancement degree,enhancement density and molecular subtypes of CESM lesions was carried out.Result:Among the 44 patients with breast cancer,32 were invasive carcinoma,5 were intraductal carcinoma in situ,5 were invasive carcinoma with intraductal carcinoma in situ,1 was invasive carcinoma with papillary carcinoma,and 1 was intraductal carcinoma with papillary carcinoma.Luminal A,Luminal B,HER-2 overexpression type,and triple negative type were 10 cases(22.73%),17 cases(38.64%),10 cases(22.73%),and 7 cases(15.90%),respectively.There were no significant differences in age,tumor size,shape,microcalcification,burr sign,enhancement degree and enhancement density between breast cancer and CESM in different molecular subtypes(P>0.05).Pin-wise comparison:Luminal A and Luminal B had statistical significance in microcalcification(P<0.05).The intensity of reinforcement was statistically significant between Luminal B and triple negative(P<0.05).Conclusion:The morphological characteristics of breast cancer CESM can partially predict the molecular subtypes of breast cancer,and it has great reference value in the diagnosis,treatment and prognosis 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 分子亚型 

分 类 号：R737.9[医药卫生—肿瘤]