非特殊型浸润性乳腺癌超声造影特征与Ki-67表达的相关性  

Correlation between contrast-enhanced ultrasound features and Ki-67 expression in invasive breast carcinoma of non-specific type

作　　者：张瑾晖 王娟[1] 姜珏[1] 何鑫[1] 井佳瑜 梁汝娜 周茹 周琦[1] ZHANG Jinhui;WANG Juan;JIANG Jue;HE Xin;JING Jiayu;LIANG Runa;ZHOU Ru;ZHOU Qi(Ultrasound Research Office,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 710004,China)

机构地区：[1]西安交通大学第二附属医院医用超声研究室,陕西西安710004

出　　处：《中华实用诊断与治疗杂志》2023年第10期973-977,共5页Journal of Chinese Practical Diagnosis and Therapy

基　　金：陕西省重点研发计划项目(2023-YBSF-392,2023-YBSF-513)。

摘　　要：目的观察非特殊型浸润性乳腺癌(IBC-NST)超声造影声像特征,分析其与Ki-67表达的相关性。方法2021年2月—2022年1月西安交通大学第二附属医院诊治IBC-NST患者101例,术前均行超声造影检查,记录超声造影定性指标(增强模式、增强幅度、造影剂分布、造影剂填充顺序、病灶范围、病灶边界、灌注缺损、周围汇聚征)及定量指标(峰值强度、上升时间、达峰时间、平均渡越时间)。手术切除病灶组织行免疫组织化学检查,采用SP法检测Ki-67表达,根据Ki-67阳性细胞百分比将101例患者分为Ki-67高表达组(≥14%)70例和Ki-67低表达组(<14%)31例。采用Spearman相关法分析IBC-NST患者病灶超声造影定性指标及定量指标与Ki-67表达的相关性。结果101例患者中造影剂分布不均匀56例(55.4%),造影剂呈向心性填充47例(46.5%),造影后病灶范围扩大56例(55.4%),病灶边界不清56例(55.4%),灌注缺损53例(52.5%),周围汇聚征56例(55.4%);增强模式中,快速进入68例(67.3%),同时进入27例(26.7%),缓慢进入6例(6.0%);增强幅度中,高增强69例(68.3%),等增强20例(19.8%),低增强5例(5.0%),无增强7例(6.9%)。Ki-67高表达组造影剂分布不均匀、病灶范围扩大、有灌注缺损、有周围汇聚征比率(65.7%、64.3%、61.4%、62.9%)均高于Ki-67低表达组(32.3%、35.5%、32.3%、38.7%)(P<0.05),增强模式、增强幅度、造影剂填充顺序、病灶边界与Ki-67低表达组比较差异均无统计学意义(P>0.05)。IBC-NST患者病灶造影剂分布、病灶范围、灌注缺损、周围汇聚征与Ki-67表达均呈正相关(r=0.310,P=0.002;r=0.267,P=0.007;r=0.269,P=0.006;r=0.224,P=0.024),增强模式、增强幅度、造影剂填充顺序、病灶边界与Ki-67表达均无相关性(P>0.05)。Ki-67高表达组病灶整体、病灶边缘区、病灶中间区峰值强度[(658.35±580.45)%、(743.33±583.01)%、(1583.72±678.30)%]均高于Ki-67低表达组[(553.27±501.31)%、(667.05±441.33)%、(1344.54±794.0Objective To observe the features of contrast-enhanced ultrasound(CEUS)of invasive breast carcinoma of non-specific type(IBC-NST),and to investigate the correlation between CEUS features and Ki-67expression.Methods From February 2021 to January 2022,101 patients with IBC-NST were diagnosed and treated in the Second Affiliated Hospital of Xi'an Jiaotong University.CEUS examination was performed before operation to record the qualitative parameters(enhancement mode,enhancement amplitude,contrast agent distribution,contrast agent filling sequence,lesion area,lesion boundary,perfusion defect,peripheral convergence sign)and the quantitative parameters(peak intensity,rising time,time to peak,mean transit time).The resected lesion tissues were performed immunohistochemical examination.The Ki-67 expression was detected by SP method.According to the percentage of Ki-67 positive cells,101 patients were divided into 70 patients with Ki-67≥14%(high-expression group)and 31 patients with Ki-6714%(low-expression group).Spearman correlation method was used to analyze the correlations of qualitative and quantitative parameters of CEUS with Ki-67 expression in IBC-NST patients.Results Among 101patients,there were 56 patients(55.4%)with uneven distribution of contrast agent,47 patients(46.5%)with centriolar filling of contrast agent,56 patients(55.4%)with enlarged lesion scope,56 patients(55.4%)with unclear lesion boundary,53 patients(52.5%)with perfusion defect,and 56 patients(55.4%)with peripheral convergence.In the enhancement mode,the contrast agent entered rapidly in 68 patients(67.3%),simultaneously in 27 patients(26.7%)and slowly in 6 patients(6.0%).The contrast enhancement amplitude showed high in 69 patients(68.3%),showed equal in 20 patients(19.8%),showed low in 5 patients(4.9%),and showed no enhancement in 7 patients(6.9%).The percentages of uneven distribution of contrast agent,enlarged lesion area,perfusion defect and peripheral convergence sign were higher in high-expression group(65.7%,64.3%,61.4%,62.9%)than those

关 键 词：非特殊型浸润性乳腺癌 超声造影 定性 定量 KI-67 

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