绝经后乳腺浸润性导管癌超声表现与雌激素受体、孕激素受体表达的关系

The relationships between Ultrasonographic Features and the Expression of estrogen receptor and progesterone receptor in Postmenopausal Women with Infiltrating Ductal Carcinoma of Breast

目的探讨绝经后乳腺浸润性导管癌二维及彩色多普勒超声表现与雌激素受体(ER)、孕激素受体(PR)表达的关系,评价超声表现术前预测ER、PR表达的可行性。方法对空军总医院2002年6月-2007年6月收治的经手术病理最终证实的96例绝经后乳腺浸润性导管癌临床资料进行分析,比较超声声像图特征与术后标本免疫组织化学染色的ER、PR表达水平。结果ER、PR阳性表达率分别为54.17%(52/96)、50%(48/96)。ER、PR双阳性、双阴性表达率分别为41.67%(40/96)、37.5%(36/96),超声表现为蟹足状或毛刺状乳癌中,ER有较高的阳性表达率(P<0.05),内部回声不均质及后方有声衰减组乳癌中,ER、PR单阳性及共同阳性均有较高的表达(P<0.05)。当ER、PR共同阴性表达时,肿块内血流信号增多(P<0.05)。结论绝经后乳腺浸润性导管癌二维及彩色多普勒超声表现可大致反映ER、PR的表达水平,联合ER、PR的表达检测对判断预后及指导治疗具有临床价值。

Objective To investigate the relationships between of 2-dimensional （2D） and color Doppler ultrasonographic features and the expressions of both estrogen receptor （ER） and progesterone receptor （PR） in postmenopausal women with infiltrating ductal carcinoma （IDC） in breast, and to evaluate the feasibility of predicting the expressions of ER and PR in IDC by means of ultrasonographic features. Methods The clinical data of 96 patients with breast infiltrating ductal carcinoma diagnosed by pathology during Jun. 2002 to Jun. 2007 were retrospectively analyzed. The correlation between ultrasonographic features and both ER and PR expressions in the mastectomy specimens determined by immunohistochermcal technique was statistically analyzed. Results Of the 96 cases, the positive expression rates of ER and PR were 54.17% and 50%, respectively, the hi-positive and hi-negative expression rates of ER and PR were 41.67% and 37. 5%, respectively. Among the breast carcinoma, the positive expression rate of ER was higher in tumor with ultrasonographic spicule sign （P〈0. 05）, the positive expression rate of ER and PR and the bi-positive expression rate of ER and PR were higher in tumors which showed heterogeneous internal echo and echo attenuation （P〈0. 05）. When ER and PR expressed coherently, the blood flow of tumor mass increased gradually （ P〈0. 05）. Condtesions 2D and color Doppler utrasonographic features may be used to roughly predict the expression level of ER and PR in postmenopausal women with infiltrating ductal carcinoma of breast, in which the detection of combined expression of ER and PR is helpful for directing therapy and judging prognosis.