不同浸润程度乳腺癌的鉴别:基于B型超声灰度图像直方图分析方法的定量研究

Using quantitative B-mode gray scale ultrasound histogram analysis to determine the infiltration degree in breast cancer

目的:评价基于B型超声灰度图像直方图分析(histogram analysis,HA)方法在鉴别不同浸润程度乳腺癌中的效能和价值。方法:收集224例经手术后病理学检查证实的乳腺癌患者,回顾并分析术前超声图像。采用美国GE公司的Omni-Kinetics软件对超声图像进行处理,于肿瘤区和正常乳腺腺体区勾画感兴趣区,分别生成18个HA定量参数。采用组内相关系数(intraclass correlation coefficient,ICC)对2名观测者测量参数的信度进行评价。为消除个体差异,采用相对值(瘤区/对照区)的形式进行统计分析比较。3组间(无浸润、早期浸润、浸润)的比较采用非参数检验(Kruskal-Wallis H检验),将组间差异有统计学意义的参数纳入多元有序logistic回归模型进一步分析处理。结果:所有18个直方图定量参数一致性良好,ICC为0.799~0.997。除最小值(Min intensity)和平均差(Mean deviation)之外,其余16个参数的相对值差异均有统计学意义。多元有序logistic回归分析显示平均值(Mean intensity),偏度(Skewness),均质度(Uniformity),5%(Quantile5)、10%(Quantile10)、75%(Quantile75)、90%(Quantile90)分位数的相对值有助于不同浸润程度乳腺癌的组间鉴别。结论:从超声灰度图像中衍生的HA参数,能够用于不同浸润程度乳腺癌的定量分析和鉴别诊断。

Objective:To evaluate the diagnostic value of histogram analysis using B-mode gray-scale ultrasound histogram analysis(HA)to determine the infiltration degree in breast cancer.Methods:A total of 224 patients with surgically confirmed breast cancer were enrolled in this study.Ultrasound features of patients were reviewed retrospectively.Eighteen HA parameters were derived using Omni-Kinetics software(GE Healthcare).The reproducibility of those parameters was evaluated using two independent delineations conducted by two observers.In order to minimize the potential influence of individual differences,the relative value of each HA parameter was used for statistical analysis.These relative value of HA parameters were compared among the three different infiltration degree in breast cancer(non-invasive,early invasive and invasive breast cancer)using Kruskal-Wallis H test and multivariable ordered logistic regression analysis.Results:All the 18 parameters presented excellent reproducibility,with intraclass correlation coefficient(ICC)values from 0.799 to 0.997.Except for Min intensity and Mean deviation,there were statistically difference in the other 16 parameters relative values.Multivariate logistic regression showed that the relative values of Mean intensity,Skewness,Uniformity,Quantile5,Quantile10,Quantile75,and Quantile90 were helpful to determine the infiltration degree in breast cancer.Conclusion:HA parameters derived from ultrasound can be used as a reliable quantitative tool to determine the infiltration degree in breast cancer.