超声应变弹性成像及免疫组化指标诊断乳腺微小癌的临床价值研究  

The Study on the Clinical Value of Ultrasound Strain Elastography and Immunohistochemical Indicators in the Diagnosis of Breast Microcarcinoma

作　　者：刘霞[1] 闫国珍[2] 李爱华 贾晓菲 Liu Xia;Yan Guozhen;Li Aihua;Jia Xiaofei(Graduate School of Baotou Medical College,Inner Mongolia University of Science&.Technology,Baotou,InnerMongolia 014040,China;Department of Ultrasound,The First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science&.Technology,Baotou,Inner Mongolia O14010,China;Depatment of Breast Surgery,The First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science&.Technology,Baotou,Inner Mongolia O14010,China)

机构地区：[1]内蒙古科技大学包头医学院研究生院,内蒙古包头市014040 [2]内蒙古科技大学包头医学院第一附属医院超声科,内蒙古包头市014010 [3]内蒙古科技大学包头医学院第一附属医院乳腺外科,内蒙古包头市014010

出　　处：《中国超声医学杂志》2024年第6期642-645,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨超声应变弹性成像(SE)对乳腺微小癌的诊断价值及其与肿瘤超声特征、免疫组化指标的相关性。方法 选取乳腺肿块直径≤1 cm的患者73例,共87个病灶。先行乳腺常规超声检查,按乳腺影像报告和数据系统(BI-RADS)分级后行SE检查,测量应变率比值(SR)。依据病理结果,绘制受试者工作特征(ROC)曲线并确定SR的最佳截断值,分析BI-RADS分类与SR对乳腺微小癌的诊断价值;探讨SR与肿瘤超声特征、免疫组化指标的表达情况及乳腺癌分子分型间的相关性。结果 病理结果:87个病灶中,恶性51个,良性36个;BI-RADS分类与SR联合具有较高的诊断价值;恶性病灶SR明显高于良性病灶(9.87±6.73 vs. 4.26±2.59,P<0.001);肿瘤大部分超声特征与SR具有统计学意义(P<0.05);HER-2及Ki-67的表达情况与SR均呈正相关(P<0.05);SR与乳腺癌分子亚型间无统计学意义(P>0.05),且组间无统计学意义(P>0.05)。结论 SR联合常规超声可提升乳腺微小癌的早期诊断效能,可为临床提供一定的生物学依据。Objective To investigate the diagnostic value of strain elastography(SE)in breast microcarcinoma and its correlation with tumor ultrasound features,immunohistochemical indicators.Methods Seventy-three patients with breast mass<1 cm in diameter were selected,with a total of eighty-seven lesions.Breast ultrasound was per-formed first,and SE examination was performed after breast imaging reporting and data system(BI-RADS)classifica-tion to measure strain ratio(SR).According to the pathological results,the receiver operating characteristic(ROC)curve was drawn and the optimal cut-off value of SR was determined,and the diagnostic value of BI-RADS classifica-tion and SR for breast microcarcinoma was analyzed.to investigate the correlation between SR and tumor ultrasound features,expression of immunohistochemical indicators and molecular classification of breast cancer.Results Patho-logical results:Among eighty-seven breast lesions,fifty-one cases were malignant and thirty-six cases were benign.BI-RADS classification combined with SR had high diagnostic value.The SR of malignant lesions was significantly higher than that of benign lesions(9.87±6.73 vs.4.26±2.59.P<0.001).Most of the ultrasound features of the tumor were correlated with SR(P<0.05).The expression of HER-2 and Ki-67 were positively correlated with SR(P<0.05).There was no significant correlation between SR and breast cancer subtypes(P>0.05)and no difference between groups(P>0.05).Conclusions The combined of SR and conventional ultrasound can improve the early di-agnosis efficiency of microcarcinoma and may provide certain biological basis for clinical practice.

关 键 词：超声应变弹性成像 应变率比值 乳腺微小癌 肿瘤超声特征 免疫组化指标 

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]