二维超声特征联合超声弹性应变率比值在乳腺癌中的诊断价值及与病理预后指标的相关性分析  

Diagnostic value of breast cancer with 2D ultrasound features combined with ultrasonic elastic strain rate ratio and correlation analysis with pathological prognostic indicators

作　　者：吴静 李景 WU Jing;LI Jing(Department of Ultrasound Medicine,The Second Affiliated Hospital of Chengdu Medical College(China National Nuclear Corporation 416 Hospital),Chengdu 610051,China)

机构地区：[1]成都医学院第二附属医院(核工业四一六医院)超声医学科,四川成都610051

出　　处：《中国医学物理学杂志》2024年第2期175-180,共6页Chinese Journal of Medical Physics

基　　金：四川省卫计委科研课题(17PJ437);成都医学院专项科学研究基金(FYZX17017)。

摘　　要：目的:分析二维超声特征联合超声弹性应变率比值(SR)在乳腺癌中的诊断价值及与病理预后指标的相关性。方法:选取2020年1月~2021年12月成都医学院第二附属医院收治的265例乳腺肿瘤患者临床资料。经病理检查确诊:良性病变171例(良性组),恶性病变94例(恶性组)。收集二维超声及超声弹性成像检查图像资料,对比两组二维超声表现特征、SR值,并统计雌激素受体(ER)、孕激素受体(PR)、原癌基因(CerbB-2)阳性率。绘制受试者工作特征(ROC)曲线,计算二维超声、SR值对乳腺癌诊断效能,以Pearman相关性分析二维超声征象、SR值与ER、PR、CerbB-2相关性。结果:恶性组二维超声特征中有毛刺征、后方回声衰减、微钙化、淋巴结转移、血流丰富者及SR值明显高于良性组(P<0.05)。恶性组ER、PR、CerbB-2阳性率分别为59.57%、75.53%、47.87%,明显高于良性组(P<0.05)。绘制ROC曲线显示,二维超声、SR值对乳腺癌诊断价值AUC值分别为0.586、0.743,联合诊断AUC值为0.761,联合检测效果明显高于两者单独检测(P<0.05)。ER阳性者有毛刺征、后方回声衰减、SR值高于ER阴性者(P<0.05);PR阳性者有淋巴结转移、SR值高于PR阴性者(P<0.05);CerbB-2阳性者有微钙化、SR值高于CerbB-2阴性者(P<0.05)。经Pearman相关性分析,二维超声征象毛刺征、后方回声衰减与ER正相关,淋巴结转移与PR正相关,微钙化与CerbB-2正相关,SR值与ER、PR、CerbB-2正相关(P<0.05)。结论:二维超声特征联合超声SR值可为乳腺癌诊断提供可靠影像学信息,毛刺征、后方声衰减、淋巴结转移、微钙化征象及SR值与患者病理预后指标ER、PR、CerbB-2之间存在一定关系。Objective To analyze the diagnostic value of two-dimensional(2D) ultrasound features combined with ultrasonic elastic strain rate ratio(SR) for breast cancer and discuss their correlations with pathological prognostic indicators.Methods The clinical data of 265 patients with breast cancer admitted to the 2nd Affiliated Hospital of Chengdu Medical College from January 2020 to December 2021 were analyzed retrospectively.Through pathological examination,171 cases were diagnosed with benign lesions(benign group) and 94 cases with malignant lesions(malignant group).The 2D ultrasound and ultrasound elastography imaging data were collected and compared for the two groups in terms of ultrasound appearance and SR.The positive rates of estrogen receptor(ER),progesterone receptor(PR),and proto-oncogene(CerbB-2) were recorded.Receiver operating characteristic(ROC) curve was drawn to analyze the diagnostic efficiency of 2D ultrasound and SR for breast cancer;and Pearman correlation analysis was conducted to assess the correlations between 2D ultrasound features/SR and ER/PR/CerbB-2.Results The 2D ultrasound features such as spicule sign,posterior echo attenuation,microcalcification,lymph node metastasis,and abundant blood flow were more common in malignant group,and the SR was significantly higher than that in benign group(P<0.05).The positive rates of ER,PR and CerbB-2 in malignant group were 59.57%,75.53% and47.87%,respectively,significantly higher than those in benign group(P<0.05).ROC curve analysis showed that the AUC values of 2D ultrasound,SR,and their combination for breast cancer diagnosis were 0.586,0.743,and 0.761,respectively,indicating a significantly higher diagnostic efficiency of the combined detection than 2D ultrasound or SR alone(P<0.05).The occurrences of spicule sign and posterior echo attenuation and SR were higher in ER-positive patients than in ERnegative patients(P<0.05);lymph node metastasis was more prevalent in PR-positive patients,and their SR was higher than PR-negative patients(P<0.05);CerbB-2 p

关 键 词：乳腺癌 二维超声 超声弹性应变率比值 病理 

分 类 号：R737.9[医药卫生—肿瘤]