人表皮生长因子受体-2阴性Luminal B型乳腺癌临床病理学与超声图像特征相关性研究

Study on the relationship between clinical pathology and ultrasound features of human epidermal growth factorreceptor-2 negative Luminal B-type breast cancer

目的探讨人表皮生长因子受体-2(HER-2)阴性Luminal B型乳腺癌临床病理学与超声图像特征的相关性。方法选取自2020年12月至2021年11月在北部战区总医院行乳腺癌手术的118例患者为研究对象。所有患者均于本院手术并获得相关病理结果,均为HER-2阴性。分析HER-2阴性Luminal B型乳腺癌与Luminal A型乳腺癌、三阴性乳腺癌临床病理特征和超声征象的差异。根据Ki-67及孕激素受体(PR)的表达指数将HER-2阴性Luminal B型乳腺癌患者分为Luminal B1组、Luminal B2组及Luminal B3组,并分析其相关性特点。结果3组HER-2阴性乳腺癌肿物的边界、形态、血流情况、毛刺蟹足征及淋巴结转移情况比较,差异均有统计学意义(P<0.05)。HER-2阴性Luminal B型与Luminal A型乳腺癌肿物的所有征象比较,差异均无统计学意义(P>0.05)。HER-2阴性Luminal B型与三阴性乳腺癌肿物的边界、形态、血流情况、毛刺蟹足征及淋巴结转移情况比较,差异均有统计学意义(P<0.05)。3组HER-2阴性Luminal B型乳腺癌的内部钙化及淋巴结转移情况比较,差异均有统计学意义(P<0.05);Luminal B2组与Luminal B3组淋巴结转移情况比较,差异有统计学意义(P<0.05);Luminal B1组与Luminal B3组内部钙化情况比较,差异有统计学意义(P<0.05)。结论Luminal A型与HER-2阴性Luminal B型乳腺癌的差异性并不明显,在超声征象的区分上有一定难度;HER-2阴性Luminal B型亚型间内部钙化和淋巴结转移方面有统计学差异;Ki-67高表达对乳腺癌预后不利。

Objective To investigate the correlation between clinical pathology and ultrasonographic features of Luminal B breast cancer with negative human epidermal growth factor receptor-2(HER-2).Methods A total of 118 patients undergoing breast cancer surgery in General Hospital of Northern Theater Command from December 2020 to November 2021 were selected as the study subjects.All patients underwent surgery in our hospital and obtained relevant pathological results,all of which were negative for HER-2.The differences of clinicopathological features and ultrasound signs between HER-2 negative Luminal B breast cancer and Luminal A breast cancer and triple negative breast cancer were analyzed.Patients with HER-2 negative Luminal B breast cancer were divided into Luminal B1 group,Luminal B2 group and Luminal B3 group according to the expression index of Ki-67 and progestogen receptor(PR),and their correlation characteristics were analyzed.Results There were statistically significant differences in boundary,morphology,blood flow,foot sign of hairy crab and lymph node metastasis of HER-2 negative breast cancer tumors among the three groups(P<0.05).There were no significant differences in all signs between Luminal B and Luminal A breast cancer masses with negative HER-2(P>0.05).There are statistically significant differences in boundary,morphology,blood flow,foot sign and lymph node metastasis between HER-2 negative Luminal B type and triple negative breast cancer masses(P<0.05).There were statistically significant differences in internal calcification and lymph node metastasis of HER-2 negative Luminal B breast cancer among the 3 groups(P<0.05).Lymph node metastasis in Luminal B2 group and Luminal B3 group was significantly different(P<0.05).There was statistical difference in calcification between Luminal B1 group and Luminal B3 group(P<0.05).Conclusion The difference between Luminal A type and HER-2 negative Luminal B type breast cancer is not obvious,and it is difficult to distinguish the ultrasonic signs.There are statistical differences in internal calcification and lymph node metastasis between her-2 negative Luminal B subtypes.The high expression of Ki-67 is a negative factor for the prognosis of breast cancer.