术前磁共振成像征象、超声弹性成像特征与乳腺癌患者人表皮生长因子受体2表达相关性研究  

Correlation between preoperative magnetic resonance imaging signs,ultrasonic elastography features and human epidermal growth factor receptor 2 expression in breast cancer patients

作　　者：林丹桂 王海潮 杨林根 林怀雄 刘昌华 LIN Dangui;WANG Haichao;YANG Lingen;LIN Huaixiong;LIU Changhua(Department of Medical Imaging,the 73rd Group Army Hospital of the PLA Army,Xiamen 361003,China)

机构地区：[1]解放军陆军第七十三集团军医院医学影像科,福建厦门361003

出　　处：《陕西医学杂志》2025年第5期702-706,710,共6页Shaanxi Medical Journal

基　　金：福建省卫生健康委员会医学科学研究计划项目(20221639)。

摘　　要：目的:探讨术前磁共振成像(MRI)征象、超声弹性成像特征与人表皮生长因子受体2(HER2)表达的相关性。方法:选取行手术治疗的乳腺癌患者228例,术前行MRI和超声弹性成像检查。收集患者癌组织和癌旁正常组织标本,免疫组织化学染色法检测组织中HER2表达,根据检测结果将患者分为HER2阳性组(160例)和HER2阴性组(68例)。采用多因素Logistic回归分析乳腺癌患者HER2阳性表达的影响因素。绘制受试者工作特征(ROC)曲线分析MRI征象和超声弹性成像特征对乳腺癌患者HER2阳性表达的预测价值。结果:两组患者在病灶形态、边缘方面比较差异有统计学意义(均P<0.05)。两组患者在强化方式、淋巴结转移、微钙化、边缘毛刺征、边缘分叶征、表观扩散系数(ADC)值方面比较差异有统计学意义(均P<0.05)。病灶形态不规则、非均匀强化、低ADC值、有淋巴结转移、微钙化、边缘毛刺征以及边缘分叶征是乳腺癌患者HER2阳性表达的独立危险因素(均P<0.05)。MRI征象和超声弹性成像特征(病灶形态、强化方式、淋巴结转移、微钙化、边缘毛刺征、边缘分叶征、ADC值)指标联合预测乳腺癌患者HER2阳性表达的曲线下面积(AUC)为0.879,高于各指标单独预测的AUC(均P<0.05)。结论:术前MRI征象、超声弹性成像特征与乳腺癌患者HER2阳性表达有关,采用MRI联合超声弹性成像检查对乳腺癌患者HER2阳性表达具有一定预测价值。Objective:To investigate the correlation between preoperative magnetic resonance imaging(MRI)signs,ultrasonic elastography features and human epidermal growth factor receptor 2(HER2)expression in breast cancer patients.Methods:A total of 228 breast cancer patients undergoing surgical treatment were enrolled.All patients underwent MRI and ultrasonic elastography before surgery.Tumor and adjacent normal tissue samples were collected from the patients,and HER2 expression was detected by immunohistochemical staining.Patients were divided into HER2 positive group(160 cases)and HER2 negative group(68 cases)based on the detection results.Multivariate logistic regression analysis was used to identify the influencing factors of HER2 positive expression in breast cancer patients.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of MRI signs and ultrasonic elastography features for HER2 positive expression in breast cancer patients.Results:There were significant differences between the two groups in terms of tumor shape and margin(all P<0.05).Significant differences were also observed between the two groups in enhancement pattern,lymph node metastasis,microcalcification,spiculated margin,lobulated margin and apparent diffusion coefficient(ADC)value(all P<0.05).Irregular tumor shape,spiculated margin,heterogeneous enhancement,low ADC value,lymph node metastasis,microcalcification,spiculated margin and lobulated margin were identified as independent risk factors for HER2 positive expression in breast cancer patients(all P<0.05).The combined prediction of HER2 positive expression in breast cancer patients using MRI signs and ultrasonic elastography features(tumor shape,margin,enhancement pattern,lymph node metastasis,microcalcification,spiculated margin,lobulated margin and ADC value)had an AUC of 0.879,which was higher than that of individual predictors(all P<0.05).Conclusion:Preoperative MRI signs and ultrasonic elastography features are correlated with HER2 positive expression in brea

关 键 词：乳腺癌 人表皮生长因子受体2 磁共振成像 超声弹性成像 预测价值 相关性 

分 类 号：R737.9[医药卫生—肿瘤]