多模态超声特征及血清IL-4、TNF-α检测预测三阴性乳腺癌术后复发转移的价值  

Predictive value of multimodal ultrasound characteristics combined with serum IL-4 and TNF-αdetection in postoperative recurrence and metastasis of triple-negative breast cancer

作　　者：朱金成[1] 叶航[2] 王娅囡 张霈 李晓艳 ZHU Jin-cheng;YE Hang;WANG Ya-nan(Department of Clinical Laboratory,the Second Affiliated Hospital of Shandong University of Chinese Medicine,Jinan 250000,China)

机构地区：[1]山东中医药大学第二附属医院检验科,济南250000 [2]山东中医药大学第二附属医院普外科,济南250000 [3]山东中医药大学第二附属医院超声科,济南250000

出　　处：《放射学实践》2023年第11期1452-1457,共6页Radiologic Practice

摘　　要：目的:探讨多模态超声特征及血清白介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)检测对三阴性乳腺癌术后复发转移的预测价值。方法:纳入2019年1月-2020年6月于山东中医药大学第二附属医院就诊并行手术治疗的114例三阴性乳腺癌患者作为研究对象。术前对所有患者进行常规超声、弹性成像及超声造影检查,检测血清IL-4、TNF-α水平。术后随访3年,记录复发转移情况。结果:114例三阴性乳腺癌患者中,术后复发转移者35例,未复发转移者79例。两组的临床分期、腋窝淋巴结转移及Ki-67水平差异有统计学意义(P<0.05)。术后复发转移组的肿块形态不规则、肿块边界模糊、出现钙化、硬环征、灌注缺损和周围放射状增强的比例显著高于未复发转移组,差异有统计学意义(P<0.05)。术后复发转移患者的血清IL-4及TNF-α水平显著高于术后未复发转移患者,差异有统计学差异(P<0.05)。二元Logistic回归分析结果显示,临床分期Ⅲ期、Ki-67>14%、肿块边界模糊、出现硬环征、周围放射状增强及血清TNF-α水平≥4.68 ng/mL为三阴性乳腺癌患者术后复发转移的危险因素(P<0.05)。列线图模型预测的准确性和有效性较好,具有较高的预测价值。ROC曲线分析结果显示,临床特征、多模态超声特征联合血清TNF-α水平预测三阴性乳腺癌患者术后复发转移的AUC为0.858(0.783~0.934),敏感度和特异度分别为88.6%和70.9%。结论:多模态超声特征联合血清TNF-α水平检测对三阴性乳腺癌患者术后复发转移具有一定预测价值,对指导患者临床高危因素的干预具有参考意义。Objective:This study was to investigate the predictive value of multimodal ultrasound characteristics combined with serum interleukin-4(IL-4)and tumor necrosis factor-α(TNF-α)detection in postoperative recurrence and metastasis of triple-negative breast cancer.Methods:114 patients with triple-negative breast cancer who received concurrent surgical treatment in The Second Affiliated to Shandong University of Traditional Chinese Medicine Hospital from January 2019 to June 2020 were included as the study objects.The levels of serum IL-4 and TNF-αwere detected,and routine ultrasound,elastography and contrast-enhanced ultrasound were performed before operation.The patients were followed up for 3 years and the recurrence and metastasis were recorded.Results:There were 35 patients with recurrence and metastasis and 79 patients without recurrence and metastasis in 114 cases of triple-negative breast cancer.There were significant differences in clinical stage,axillary lymph node metastasis,and Ki-67 levels between the two groups(P<0.05).The proportion of irregular tumor shape,blurred tumor boundary,calcification,hard ring sign,perfusion defect and peripheral radial enhancement in postoperative recurrence and metastasis group was significantly higher than that in non-recurrence and metastasis group,with statistical significance(P<0.05).The serum levels of IL-4 and TNF-αin patients with postoperative recurrence and metastasis were significantly higher than those in patients without postoperative recurrence and metastasis,and the differences were statistically significant(P<0.05).The results of binary Logistic regression analysis showed that clinical stageⅢ,Ki-67>14%,blurred tumor boundary,hard ring sign,peripheral radial enhancement and serum TNF-αlevel≥4.68ng/mL were risk factors for postoperative recurrence and metastasis in patients with triple-negative breast cancer(P<0.05).The accuracy and effectiveness of the nomogram model was good,and it had high predictive value.ROC curve analysis results showed that the A

关 键 词：乳腺肿瘤 三阴性乳腺癌 超声 弹性成像 超声造影 IL-4 TNF-Α 

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]