小乳腺癌超声征象与其分子亚型的相关性研究  

Correlation between ultrasonographic signs and molecular typing in small breast cancer

作　　者：余小琴[1] 郭亮 王俊芳[1] 左恒玲[1] 许瑞云 陈金华[1] YU Xiaoqin;GUO Liang;WANG Junfang;ZUO Hengling;XU Ruiyun;CHEN Jinhua(Department of Ultrasound,Longgang District Central Hospital of Shenzhen,Shenzhen 518116,China;Department of Prevetive Health Devision,Longgang District Central Hospital of Shenzhen,Shenzhen 518116,China)

机构地区：[1]广东省深圳市龙岗中心医院超声科,广东深圳518116 [2]广东省深圳市龙岗中心医院预防保健管理办公室,广东深圳518116

出　　处：《医学影像学杂志》2023年第12期2224-2227,共4页Journal of Medical Imaging

基　　金：深圳市龙岗区医疗卫生科技计划项目(编号:LGKCYLWS2020014)。

摘　　要：目的探讨小乳腺癌超声征象与其分子亚型的关系。方法选取79例小乳腺癌患者的原发肿块(23个伴淋巴结转移,56个未转移)及腋窝淋巴结超声声像图特征,与病理结果对照,分析各超声声像图特征与其分子亚型的关系。结果79例小乳腺癌中非特殊类型浸润性乳腺癌所占比例最高约62.03%(49/79),4种分子亚型中Luminal B型所占比例最高约60.76%(48/79)。4种不同分子亚型小乳腺癌之间,肿块形态、边缘、微钙化、间质纤维结构改变、血流分级和淋巴结转移差异有统计学意义(P均<0.01)。组间比较显示,Luminal A型与三阴性型比较边缘毛刺、乳腺纤维间质结构改变差异有统计学意义(χ^(2)=3.909、4.232,P均<0.05);Luminal B型与三阴性型比较形态不规则、纤维间质结构改变差异有统计学意义(χ^(2)=17.719、4.232,P均<0.05);三阴性型小乳腺癌血流分级与Luminal A型、Luminal B型、HER-2型比较差异有统计学意义(χ^(2)=6.134、7.023、6.806,P均<0.05)。结论肿块形态、毛刺、纤维间质结构改变对诊断Luminal型小乳腺癌有提示作用,微小钙化、腋窝淋巴结转移对HER-2过表达型小乳腺癌有提示作用,血流信号丰富对三阴性型小乳腺癌有提示作用。小乳腺癌超声征象与其分子亚型有一定的相关性,能为临床确定治疗方案及判断预后提供重要依据。Objective To explore the correlation between ultrasonographic signs of small breast cancer and molecular typ-ing.Methods The sonographic features of 79 patients with 79 small breast malignant noplasms and axillary lymph nodes(23 with metastasis,56 without metastasis)were retrospectively analyzed.The results of ultrasonography were compared with pathol-ogy.The relationship between these signs and molecular typing were evaluated.Results In the 79 small breast malignant no-plasms,the Non-specific type of invasive breast cancer was the highest proportion,accounting for 62.03%(49/79).The type of Luminal B was the most common in the four molecular typing,accounting for 60.76%(48/79).The ultrasound lesion shape,edge,microcalcification,changes in the fascia,blood flow grade,and axillary lymph node metastasis were significantly differently to four molecular typings(P<0.05).The ultrasound lesion spiculated and changes in the fascia were statistically significant to Lumi-nal A and Basal typing(χ²=3.909,4.232,P<0.05).The ultrasound lesion irregular and changes in the fascia were statistically sig-nificant to Luminal B and Basal typing(χ²=17.719,4.232,P<0.05).The ultrasound lesion blood flow grade was statistically sig-nificant to basal and other three molecular typing(χ²=6.134,7.023,6.806,P<0.05).Conclusions The ultrasound lesion shape,spiculated and changes in the fascia may diagnose Luminal typing.The ultrasound lesion microcalcification and axillary lymph node metastasis may diagnose HER-2 typing.II–III blood flow grade may diagnose Basal typing.The ultrasound signs of small breast cancer are correlated with their molecular subtypes,which can provide an important basis for clinical treatment and prognosis.

关 键 词：小乳腺癌 分子亚型 超声检查 

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