超声弹性成像联合EZH2、BRCA1蛋白对三阴性乳腺癌的诊断价值  

Analysis of the diagnostic value of ultrasound elastography combined with EZH2 and BRCA1 proteins in triple-negative breast cancer

作　　者：杨静[1] 朱娟英[2] 赵莹[1] 凌利[1] 朱晓萍[2] 陈冬冬[1] Yang Jing;Zhu Juanying;Zhao Ying;Ling Li;Zhu Xiaoping;Chen Dongdong(Ultrasound Department,Jiaxing Maternal and Child Health Hospital,Jiaxing 314000,China;Breast Department,Jiaxing Maternal and Child Health Hospital,Jiaxing 314000,China)

机构地区：[1]嘉兴市妇幼保健院超声科,嘉兴314000 [2]嘉兴市妇幼保健院乳腺科,嘉兴314000

出　　处：《中华内分泌外科杂志》2023年第5期545-549,共5页Chinese Journal of Endocrine Surgery

基　　金：浙江省医药卫生科技计划项目(2018PY070)。

摘　　要：目的探讨超声弹性成像联合Zeste增强子同源物2(enhancer of Zeste homolog 2,EZH2)、乳腺癌易感基因1(breast cancer susceptibility gene 1,BRCA1)蛋白对三阴性乳腺癌(triple negative breast cancer,TNBC)的诊断价值。方法选择嘉兴市妇幼保健院2019至2021年间进行治疗的的乳腺癌患者,共有116例,依据患者的雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人表皮生长因子受体2(human epidermalgrowth factor receptor-2,HER2)的表达情况,将ER、PR、HER2均为阴性的患者归为三阴性乳腺癌(triple negative breast cancer,TNBC)组,共21例,将ER、PR、HER2任何一项为阳性者的患者归为非TNBC,共95例。入组患者均行超声弹性成像检查。EZH2与BRCA1的阳性表达情况用免疫组化法进行检测。χ2检验分析超声弹性成像联合EZH2、BRCA1蛋白对TNBC的诊断价值。结果在TNBC组中其病灶边缘光滑(35.09)和分叶(9.52)的比例高于非TNBC组(12.63,5.26),而毛刺(28.57)、模糊(23.81)比例低于非TNBC组(50.53,31.58);TNBC组钙化(52.38)比例低于非TNBC组(85.26);后方回声无衰减(80.95)比例高于非TNBC组(52.63);血流分级富血供(57.14)比例低于非TNBC组(63.16)(均P<0.05)。TNBC组的EZH2阳性表达率(85.71)高于非TNBC的阳性表达率(63.16)(P<0.001),TNBC组的BRCA1阳性表达率(19.05)低于非TNBC的阳性表达率(55.79)(P<0.05);TNBC组中EZH2阳性者后方回声无衰减(88.89)比例和富血供比例(88.89)均高于阴性者(33.33,0)(均P<0.05),TNBC组中BRCA1阳性者后方回声无衰减比例(25.00)和富血供比例(25.00)均低于阴性者(52.94,88.24)(均P<0.05)。依据病理结果,后方回声对TNBC诊断的敏感性、特异性、准确度分别为25.37%、91.84%、53.44%;EZH2敏感性、特异性、准确度分别为23.08%、92.11%、45.69%;BRCA1敏感性、特异性、准确度分别为28.81%、92.98%、60.34%;三者联合敏感性、特异性、准确度分别为53.13%、95.24%、83.62%。血流分级对TNBC诊断的敏感�Objective To investigate the diagnostic value of ultrasound elastography combined with enhancer of Zeste homolog 2(EZH2)and breast cancer susceptibility gene 1(BRCA1)proteins in triple-negative breast cancer.Methods A total of 116 breast cancer patients selected for treatment in our hospital from 2019 to 2021 were analyzed,and ER and PR were analyzed according to the expression of estrogen receptor(ER),progesterone receptor(PR),and human epidermal growth factor receptor-2(HER2).Patients who were all HER2 negative were classified as TNBC group,with a total of 21 cases,and patients who were positive for ER,PR,and HER2 were classified as non-TNBC,a total of 95 cases.All enrolled patients underwent ultrasonic elastography examination.The positive expression of EZH2 and BRCA1 was detected by immunohistochemistry.Chi-square test was used to analyze the diagnostic value of ultrasound elastography combined with EZH2 and BRCA1 proteins in TNBC.Results In the TNBC group,the proportion of smooth edges(35.09)and lobulation of lesions(9.52)was higher than that in the non-TNBC group(12.63,5.26),while the proportion of burrs(28.57)and fuzziness(23.81)was lower than that in the non-TNBC group(50.53,31.58).The proportion of calcifications(52.38)in the TNBC group was lower than that in the non-TNBC group(85.26).The non-attenuation ratio of rear echo(80.95)was higher than that of non-TNBC group(52.63).The proportion of blood flow grade enrichment(57.14)was lower than that in the non-TNBC group(63.16)(all P<0.05).The positive expression rate of EZH2 in the TNBC group(85.71)was higher than that of non-TNBC(63.16)(P<0.001),and the positive expression rate of BRCA1 in the TNBC group(19.05)was lower than that of non-TNBC(55.79)(P<0.05).The posterior echo non-attenuation ratio(88.89)and rich blood supply ratio(88.89)of EZH2 positive patients in the TNBC group were higher than those with negative(33.33,0)(all P<0.05),and the rear echo non-attenuation ratio(25.00)and rich blood supply ratio(25.00)of BRCA1 positive in the TNBC group were lo

关 键 词：超声弹性成像 Zeste增强子同源物2 乳腺癌易感基因1 三阴性乳腺癌 

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]