超声弹性成像参数与乳腺癌OPN、VEGF-C表达关系及联合预测预后价值  

The Relationship Between Ultrasonic Elastography Parameters and the Expression of OPN and VEGF-C in Breast Cancer and the Prognostic Value of Combined Prediction

作　　者：王洋 赵雪 王思思 边今怡 杜云龙 李建宁[3] Wang Yang;Zhao Xue;Wang Sisi;Bian Jinyi;Du Yunlong;Li Jianning(Department of Ultrasound,Shandong Public Health Clinical Center,Jinan 250000,China;Department of Breast and Thyroid Surgery,Shandong Public Health Clinical Center,Jinan 250000,China;Department of Ultrasound,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250000,China)

机构地区：[1]山东省公共卫生临床中心超声科,济南市250000 [2]山东省公共卫生临床中心乳腺甲状腺外科,济南市250000 [3]山东中医药大学附属医院超声医学科,济南市250000

出　　处：《中国超声医学杂志》2024年第7期744-748,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨超声弹性成像参数与乳腺癌骨桥蛋白(OPN)、血管内皮生长因子-C(VEGF-C)表达的关系及联合预测预后价值。方法 回顾性收集行手术治疗的102例乳腺癌患者临床资料。依据术后3年是否出现复发转移分为预后不良组(出现术后复发转移)、预后良好组(未出现术后复发转移)。术前均行超声剪切波弹性成像(SWE)检查,取手术切除标本以免疫组化法测定OPN、VEGF-C表达阳性率。使用Shell功能测定病灶内部组织、病灶边界外扩1 mm、2 mm、3 mm区域内组织的最大弹性模量值(Emax),即A-Emax、Shell 1 Emax、Shell 2 Emax、Shell 3 Emax,探究SWE参数及OPN、VEGF-C表达对患者术后预后的预测效力,并观察SWE参数与OPN、VEGF-C表达的关系。结果 预后不良组A-Emax、Shell 1 Emax、Shell 2 Emax、Shell 3 Emax等SWE参数及OPN、VEGF-C表达阳性率均高于预后良好组(P<0.05)。Spearman相关系数分析显示,乳腺癌患者A-Emax、Shell 1 Emax、Shell 2 Emax、Shell 3 Emax值与OPN、VEGF-C表达阳性率均呈正相关(P<0.05)。绘制受试者工作特征曲线分析可知,A-Emax、Shell 1 Emax、Shell 2 Emax、Shell 3 Emax及OPN、VEGF-C表达均对乳腺癌患者术后预后预测具有一定价值,各指标联合预测时曲线下面积为0.935,高于单一指标,预测灵敏度为89.66%,特异度为89.04%。结论 SWE参数与乳腺癌患者OPN、VEGF-C表达有关,且两者联合对患者预后具有良好预测效能,可为预后评估及临床治疗方案制订提供参考。Objective To investigate the relationship between ultrasonic elastography parameters and the expression of osteopontin(OPN) and vascular endothelial growth factor-C(VEGF-C) in breast cancer and their prognostic value.Methods The clinical data of 102 patients with breast cancer who underwent surgical treatment were retrospectively collected.According to whether there was recurrence and metastasis 3 years after operation,they were divided into poor prognosis group(recurrence and metastasis after operation) and good prognosis group(no recurrence and metastasis after operation).Shear wave elastography(SWE) was performed before operation,and the positive rates of OPN and VEGF-C expression were determined by immunohistochemistry in surgical resection tissue samples.The predictive effect of SWE parameters,OPN and VEGF-C expression on postoperative prognosis of patients was explored.The relationship between SWE parameters and the expression of OPN and VEGF-C was evaluated.Results The SWE parameters such as A-maximum elastic modulus(Emax),Shell 1 Emax,Shell 2 Emax,Shell 3 Emax and the positive expression rates of OPN and VEGF-C in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Spearman correlation coefficient analysis showed that the values of A-Emax,Shell 1 Emax,Shell 2 Emax and Shell 3 Emax in breast cancer patients were positively correlated with the positive rates of OPN and VEGF-C expression(P<0.05).The receiver operating characteristic curve analysis showed that the expression of A-Emax,Shell 1 Emax,Shell 2 Emax,Shell 3 Emax,OPN and VEGF-C had certain value in predicting the prognosis of breast cancer patients after operation.The area under the curve of the combined prediction of each index was 0.935,which was higher than that of the single index.The predictive sensitivity was 89.66%,and the specificity was 89.04%.Conclusions SWE parameters are related to the expression of OPN and VEGF-C in breast cancer patients,and the combination of the two has a good predictive value on the p

关 键 词：超声弹性成像参数 乳腺癌 骨桥蛋白 血管内皮生长因子-C 预后预测 

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