肿瘤相关巨噬细胞在乳腺癌超声造影不同区域的特点及其与临床病理的关系  

Characteristics of Tumor-Associated Macrophages in Different Regions of Breast Cancer and Their Correlation with Clinicopathology via Contrast-Enhanced Ultrasound

作　　者：崇乐 夏露花[2] 李红玉[3] 贾志莺[1] 武秀兰[1] 冷晓玲 CHONG Le;XIA Luhua;LI Hongyu;JIA Zhiying;WU Xiulan;LENG Xiaoling(不详;Department of ultrasound,the Tenth Affiliated Hospital of Southern Medical University(Dongguan people's Hospital),Dongguan 523000,China)

机构地区：[1]新疆医科大学附属肿瘤医院超声科,新疆乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院核医学科,新疆乌鲁木齐830011 [3]新疆医科大学附属肿瘤医院乳腺内科,新疆乌鲁木齐830011 [4]南方医科大学第十附属医院(东莞市人民医院)超声科,广东东莞523000

出　　处：《中国医学影像学杂志》2025年第2期158-164,共7页Chinese Journal of Medical Imaging

基　　金：国家自然科学基金(82360362);新疆维吾尔自治区杰出青年科学基金(2022D01E77)。

摘　　要：目的 研究肿瘤相关巨噬细胞(TAM)在乳腺癌超声造影不同区域的分布特点,进一步探索TAM与乳腺癌不同区域超声造影指标及临床病理的关系。资料与方法 前瞻性纳入2021年3月—2023年3月就诊于新疆医科大附属肿瘤医院119例疑似乳腺癌患者,对乳腺肿块进行超声造影,超声引导下穿刺活检取材,病理确诊为乳腺癌患者勾画病变中心区域、边缘区域及癌旁正常区域,获得不同区域的时间-强度曲线。取材组织进行免疫组化及流式细胞检查,染色并分辨出TAM细胞。分析TAM在乳腺癌不同区域的特点及其与临床病理的相关性。结果 免疫组化及流式细胞检测发现TAM在乳腺癌超声造影的边缘区域、中央区域及癌旁的浸润数量差异有统计学意义(免疫组化:F=382.326,P<0.05;流式细胞:F=24.955,P<0.05)。3个不同区域的超声造影特点显示,出现充盈缺损时乳腺癌中央区域TAM增多(t=2.631,P<0.05),但边缘区域TAM较多(t=2.999,P<0.05)。造影后呈高增强,病灶边缘及中央区域TAM较多(t=5.529,P<0.05;t=2.584,P<0.05)。临床分期与3个区域TAM有关联,临床分期较高时,3个区域TAM均较多(t=6.658、2.367、2.400,P<0.05)。组织学分级较高,3个区域的TAM均较多(F=101.151、16.922、26.822,P<0.05)。结论 TAM在乳腺癌超声造影边缘区域、中央区域、癌旁正常区域呈递减趋势。边缘区域比中央区域及癌旁正常区域恶性超声造影特征更明显,在临床分级晚、组织分化差及超声造影恶性特征明显的乳腺癌中,TAM数量更多。TAM的分布特征一定程度上代表了乳腺癌的恶性程度和转移能力,TAM是乳腺癌的侵袭性相关因素。Purpose To investigate the distribution characteristics of tumor-associated macrophages(TAM)in different regions of breast cancer with enhanced contrast-enhanced ultrasound(CEUS),and to further explore the relationship between TAM and CEUS indicators and clinicopathology in different regions of breast cancer.Materials and Methods A total of 119 patients with suspected breast cancer admitted to the Cancer Hospital Affiliated to Xinjiang Medical University from March 2021 to March 2023 were prospectively included.CEUS was applied to the tumor,and ultrasound-guided puncture biopsy was also taken.The lesions diagnosed as breast cancer by pathology was outlined the central area,marginal area and normal area next to the cancer,and was obtained the time intensity curves of different areas.The tissues were taken for immunohistochemistry and flow cytometry,and the TAM cells were stained and distinguished.The characteristics of TAM in different regions of breast cancer and its correlation with clinical pathology were analyzed,respectively.Results By immunohistochemistry and flow cytometry,there were significant differences in the number of TAM infiltration in the border area,central area and adjacent area of breast cancer(immunohistochemistry:F=382.326,P<0.05;flow cytometry:F=24.955,P<0.05).The characteristics of CEUS in three different regions showed that the TAM in the central region of breast cancer increased when filling defect appeared(t=2.631,P<0.05),but the TAM in the peripheral region was more(t=2.999,P<0.05).After angiography,lesions showed high perfusion,and there was significantly more TAM in the edge and central area of the lesion than that in normal area next to the cancer(t=5.529,P<0.05;t=2.584,P<0.05).Clinical stage was related to the TAM in three regions. When the clinical stage was high, there were more TAM in all three regions (t=6.658, 2.367, 2.400, allP<0.05). Histological grading was high, and TAM in all three areas was high (F=101.151,16.922, 26.822, all P<0.05). Conclusion There wasa decreasing trend

关 键 词：肿瘤相关巨噬细胞 乳腺肿瘤 超声造影 病理学 临床 

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