基于高频灰阶超声联合剪切波成像和彩色多普勒血流显像的模型在不同分子亚型乳腺癌鉴别诊断中的应用  

Model based on the High Frequency Gray-Scale Ultrasound Combined with Shear Wave Imaging and Color Doppler Flow Imaging Application in Differential Diagnosis of Breast Cancer with Different Molecular Subtypes

作　　者：蔡莉 Cai Li(Wuhan Central Hospital of China Construction Third Engineering Bureau,Wuhan Hubei 430223,China)

机构地区：[1]中国建筑第三工程局武汉中心医院,湖北武汉430223

出　　处：《医疗装备》2025年第2期5-9,共5页Medical Equipment

摘　　要：目的探讨基于高频灰阶超声联合剪切波成像(SWE)、彩色多普勒血流显像(CDFI)的模型在不同分子亚型乳腺癌鉴别诊断中的应用价值。方法回顾性分析2022年6月至2024年5月医院收治的129例疑似乳腺癌患者的临床资料。患者均接受高频灰阶超声、SWE、CDFI检查及组织病理学检查,根据组织病理学检查结果分为管腔型组(41例)、人表皮生长因子受体2(HER2)型组(31例)、三阴型组(26例)和良性组(31例)。比较4组的病灶超声表现和相关参数;采用Logistic回归分析病灶超声表现、参数与乳腺癌分子亚型的关系,采用Forward:LR法建立诊断模型,绘制受试者工作特征(ROC)曲线评估模型对乳腺癌分子亚型的鉴别诊断价值。结果管腔型组、HER2型组、三阴型组的病灶形态不规则、肿块最大径≥2 cm、纵横比>1、边缘不光整、肿块微钙化、Adler血流Ⅱ~Ⅲ级、阻力指数(RI)≥0.7占比高于良性组,差异有统计学意义(P<0.05),但管腔型组、HER2型组、三阴型组以上指标的组间差异无统计学意义(P>0.05)。管腔型组、HER2型组、三阴型组的杨氏模量平均值(E_(mean))、最大值(E_(max))、标准差(Esd)高于良性组,最小值(E_(min))低于良性组(P<0.05);HER2型组、三阴型组的E_(mean)、E_(max)高于管腔型组,HER2型组的Esd高于管腔型组,三阴型组的E_(min)低于管腔型组(P<0.05);三阴型组的E_(mean)、E_(max)、E_(min)低于HER2型组(P<0.05)。基于Logistic回归分析结果建立管腔型、HER2型、三阴型乳腺癌的鉴别诊断模型并进行ROC分析,结果显示模型诊断管腔型、HER2型、三阴型乳腺癌的曲线下面积(AUC)分别为0.750、0.800、0.813,灵敏度分别为51.22%、70.97%、61.54%,特异度分别为89.47%、77.61%、95.83%。结论基于高频灰阶超声表现和SWE、CDFI参数构建的模型对不同分子亚型乳腺癌具有良好的鉴别诊断价值。Objective To investigate the application value of high frequency grayscale ultrasound combined with shear wave imaging(SWE)and color Doppler flow imaging(CDFI)in the differential diagnosis of breast cancer with different molecular subtypes.Methods With a retrospective analysis of the clinical data of 129 suspected breast cancer patients admitted to the hospital from June 2022 to May 2024.With the all patients undergoing high frequency gray-scale ultrasound,SWE,CDFI and histopathological examination,they were divided into lumen type group(41 cases),human epidermal growth factor receptor 2(HER2)type group(31 cases),triple negative type group(26 cases)and benign group(31 cases)according to histopathological examination.The ultrasound manifestations and related parameters of the lesions in four groups were compared.The relationship between ultrasound manifestations and parameters of lesions and molecular subtypes of breast cancer was analyzed by using Logistic regression,and the model was established.The receiver operating characteristic(ROC)curve was drawn to evaluate the value of the model in the differential diagnosis of molecular subtypes of breast cancer.Results The proportions of lesions with irregular morphology,maximum diameter≥2 cm,aspect ratio>1,uneven edges,microcalcifications,Adler blood flow with gradeⅡ-Ⅲ,and resist index(RI)≥0.7 in the lumen type group,HER2 type group,and triple negative type group was higher than that in the benign group,and the differences were statistically significant(P<0.05);However,there were no significant differences in the above indicators among lumen type group,HER2 type group and triple negative type groups(P>0.05).The mean value(E_(mean)),maximum value(E_(max))and standard deviation(Esd)of Young's modulus in lumen type group,HER2 type group,and triple negative type group were higher than those in benign group,while the minimum value(E_(min))was lower than that in benign group(P<0.05).The E_(mean) and E_(max) in HER2 type group and triple negative type group were high

关 键 词：高频灰阶超声 剪切波成像 彩色多普勒血流显像 乳腺癌 分子亚型 

分 类 号：R445.1[医药卫生—影像医学与核医学]