剪切波弹性成像联合常规超声参数与乳腺癌新型雌激素受体GPER表达的相关性及临床意义  

Correlation and Clinical Significance of Shear Wave Elastography Combined with Conventional Ultrasound Parameters and GPER Expression in Breast Cancer

作　　者：徐雪 余腾骅 曾小强 黄先明[1] 袁新春[3] XU Xue;YU Tenghua;ZENG Xiaoqiang(The First Affiliated Hospital of Nanchang University,Nanchang,330000)

机构地区：[1]江西省肿瘤医院,330000 [2]南昌大学医学部,330000 [3]南昌大学第一附属医院,330000

出　　处：《实用癌症杂志》2024年第12期1987-1991,2012,共6页The Practical Journal of Cancer

基　　金：国家自然科学基金项目(编号:82160565);江西省赣鄱俊才支持计划(编号:20232BCJ23035)。

摘　　要：目的探讨剪切波弹性成像(SWE)定量参数联合常规超声参数与乳腺癌新型雌激素受体GPER表达的相关性及其临床意义。方法术前对63例乳腺肿块(术后均确诊乳腺癌)行常规超声和SWE检查。常规超声获取病灶最大径,血流阻力指数(RI),SWE检查测量病灶最大弹性值Emax。以术后病理结果为金标准,记录患者年龄、月经状态、肿瘤组织学分级、有无淋巴结转移、TNM分期等。采用免疫组化法检测GPER在肿瘤间质与实质中的表达。分析Emax在肿瘤实质或间质GPER不同表达间的差异及其与临床病理参数的相关性。结果Emax与肿瘤间质GPER表达有显著相关性(P<0.05)。Emax与肿瘤实质GPER的表达无明显相关性(P>0.05)。Emax与肿瘤大小、RI、腋窝淋巴结状态、组织学分级、临床TNM分期有显著相关性(P<0.05)。肿瘤间质GPER的表达与肿瘤大小、RI、腋窝淋巴结状态、临床TNM分期均有显著相关性(P<0.05),与患者年龄、月经状态及组织学分级无明显相关性(P>0.05)。而肿瘤实质GPER的表达则与以上临床参数均无明显相关性(P>0.05)。结论SWE定量参数Emax与乳腺癌间质GPER的表达有显著相关性,且两者表达均与乳腺肿瘤大小、RI、腋窝淋巴结状态及临床分期密切相关,术前SWE超声检查联合病理肿瘤间质GPER表达分析可能成为预测乳腺癌患者预后的新方法,为临床个体化治疗提供理论依据。Objective To explore the correlation between quantitative parameters of shear wave elastography(SWE)combined with conventional ultrasound parameters and the expression of GPER in breast cancer and its clinical significance.Methods Routine ultrasonography and SWE were performed in 63 cases of breast masses(all diagnosed with breast cancer after operation)before operation.Conventional ultrasound obtains the maximum diameter of the lesion,blood flow resistance index(RI),and SWE examination measures the maximum elasticity value Emax of the lesion.Using postoperative pathological results as the gold standard,record patient age,menstrual status,tumor histological grading,presence of lymph node metastasis,TNM staging,etc.Use immunohistochemistry to detect the expression of GPER in tumor stroma and parenchyma.Results There was a significant correlation between Emax and the expression of GPER in tumor stroma(P<0.05).There was no significant correlation between Emax and GPER expression in tumor tissue(P>0.05).Emax was significantly correlated with tumor size,RI,axillary lymph node status,histological grading,and clinical TNM staging(P<0.05).The expression of GPER in tumor stroma was significantly correlated with tumor size,RI,axillary lymph node status,and clinical TNM staging(P<0.05),but not significantly correlated with patient age,menstrual status,and histological grading(P>0.05).The expression of GPER in tumor parenchyma showed no significant correlation with the above clinical parameters(P>0.05).Conclusion The quantitative parameter Emax of SWE is related to the expression of GPER in the interstitial tissue of breast cancer,and both expressions are closely related to the size of breast tumor,RI,axillary lymph node status and clinical stage.Preoperative SWE ultrasonography combined with pathological analysis of GPER expression in the interstitial tissue of breast cancer may become a new method to predict the prognosis of breast cancer patients,and provide theoretical basis for clinical individualized treatment.

关 键 词：剪切波弹性成像 乳腺癌 GPER 临床治疗 预后 

分 类 号：R737.9[医药卫生—肿瘤]