Sonazoid超声造影技术与波形蛋白葡萄糖转运蛋白-1钙调节蛋白及P63蛋白表达对乳腺癌前哨淋巴结转移的诊断价值分析  

Analysis on the value of Sonazoid ultrasound contrast,vimentin,glucose transporter-1,calmodulin,and P63 protein expressions in sentinel lymph node metastasis of breast cancer

作　　者：冯小凡 丁艺文 袁颜颜 江莹 FENG Xiao-fan;DING Yi-wen;YUAN Yan-yan;JIANG Ying(Department of Ultrasonography,Yiwu Central Hospital,Yiwu,Zhejiang 322000,China)

机构地区：[1]义乌市中心医院超声科,浙江义乌322000

出　　处：《中国妇幼保健》2025年第1期156-160,共5页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2024XY195)。

摘　　要：目的探讨Sonazoid超声造影技术与波形蛋白、葡萄糖转运蛋白-1(GLUT-1)、钙调节蛋白及P63蛋白表达对乳腺癌前哨淋巴结转移的诊断价值。方法选取2021年3月—2022年12月义乌市中心医院收治的98例乳腺癌患者为乳腺癌组;另收集同期50例乳腺良性增生患者为对照组。乳腺癌组患者术前行Sonazoid超声造影检查,评估病灶性质,诊断前哨淋巴结转移情况,并与术后前哨淋巴结组织病理学检查结果对比,分析诊断价值;切换到常规模式,扫描前哨淋巴结大小,测量前哨淋巴结的横径和纵径,计算纵横比。采用免疫组化法检测乳腺癌组和对照组乳腺组织中波形蛋白、GLUT-1、钙调节蛋白、P63蛋白表达。结果98例乳腺癌患者中,Sonazoid超声造影技术检出前哨淋巴结122个,其中增强模式A型65个(53.28%),增强模式B型49个(40.16%),增强模式C型8个(6.56%)。Sonazoid超声造影技术诊断乳腺癌前哨淋巴结转移的灵敏度为94.74%(36/38),特异度为75.00%(63/84),准确度为81.15%(99/122),阳性预测值为63.16%(36/57),阴性预测值为96.92%(63/65)。转移性前哨淋巴结横径、纵径均明显长于非转移性前哨淋巴结(均P<0.05)。乳腺癌组波形蛋白、GLUT-1、P63蛋白表达阳性率分别为76.53%、62.24%、79.59%,明显高于对照组的16.00%、12.00%、6.00%,钙调节蛋白表达阳性率为14.29%,明显低于对照组的90.00%,差异均有统计学意义(均P<0.05)。乳腺癌患者中,转移组波形蛋白、GLUT-1、P63蛋白表达阳性率分别为89.66%、86.21%、93.10%,明显高于非转移组的71.01%、52.17%、73.91%,钙调节蛋白表达阳性率为6.90%,明显低于非转移组的17.39%,差异均有统计学意义(均P<0.05)。受试者工作特征(ROC)曲线显示:横径、纵径、波形蛋白、GLUT-1、钙调节蛋白及P63蛋白对乳腺癌前哨淋巴结转移均具有较高的诊断价值(P<0.05),各指标联合检测的诊断价值最高,曲线下面积为0.975。结论术前Sonazoid超声Objective To explore the value of Sonazoid ultrasound contrast,vimentin,glucose transporter-1(GLUT-1),calmodulin,and P63 protein expressions in sentinel lymph node metastasis of breast cancer.Methods From March 2021 to December 2022,98 patients with breast cancer treated in Yiwu Central Hospital were selected as breast cancer group,50 patients with breast benign hyperplasia were selected as control group.The patients in breast cancer group underwent Sonazoid ultrasound contrast before operation,focal property was evaluated,the metastasis of sentinel lymph node was determined,then the results were compared with histopathological examination results after operation,the diagnostic value was analyzed.Conventional ultrasound was used to scan size of sentinel lymph node,transverse diameter and longitudinal diameter of sentinel lymph nodes were measured,aspect ratio was calculated.Immunohistochemical method was used to detect the expressions of vimentin,GLUT-1,calmodulin,and P63 protein in breast tissues of patients in breast cancer group and control group.Results Among 98 breast cancer patients,Sonazoid ultrasound contrast detected 122 sentinel lymph nodes,including 65 enhancement mode A lymph nodes(53.28%),49 enhancement mode B lymph nodes(40.16%),and 8 enhancement mode C lymph nodes(6.56%).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of Sonazoid ultrasound contrast in diagnosis of sentinel lymph node metastasis were 94.74%(36/38),75.00%(63/84),81.15%(99/122),63.16%(36/57),and 96.92%(63/65),respectively.The transverse diameter and longitudinal diameter of sentinel lymph node in metastasis group were significantly longer than those in non-metastasis group(P<0.05).The positive expression rates of vimentin,GLUT-1,and P63 protein in breast cancer group were 76.53%,62.24%,and 79.59%,respectively,which were significantly higher than those in control group(16.00%,12.00%,6.00%),the positive expression rate of calmodulin in breast cancer group was 14.29%,which was significantly l

关 键 词：乳腺癌 前哨淋巴结转移 Sonazoid超声造影 波形蛋白 葡萄糖转运蛋白-1 钙调节蛋白 P63蛋白 诊断价值 

分 类 号：R737.9[医药卫生—肿瘤]