乳腺癌彩色多普勒超声血流信号表现与Nottingham预后指数的相关性

Correlation Between Blood Flow Imaging of CDFI and Nottingham Prognostic Index in Patients with Breast Carcinoma

目的:探讨乳腺癌彩色多普勒超声(CDFI)血流信号表现与Nottingham Prognostic Index(诺丁汉预后指数,NPI)的关系。材料和方法:回顾性分析73例乳腺浸润性导管癌患者,采用CDFI检测乳腺癌血流信号,血流信号程度按照ADLER分为0～3级。术后病理测量肿瘤大小,评价淋巴结状态,进行组织分级。计算NPI=[肿瘤大小(cm)×0.2]+[组织学分级(1～3)]+[淋巴结状态(1～3)],NPI分为<3.4、3.4～5.4、>5.43组。计算CDFI分级与NPI各分组例数。随访乳腺癌患者手术后的目前生存状况。结果:CDFI0级NPI<3.4、3.4～5.4、>5.4例数分别为9、3、1;1级NPI3组例数为5、5、4;2级NPI3组例数为4、11、9;3级例数分别为1、8、13。秩相关检验:相关系数r=0.48728,P<0.0001。随访结果:血流信号0级、1级的患者均健康生存;血流信号2级患者中有1例发生骨转移,1例死亡;而血流信号3级的患者中,1例发生肺转移,3例死亡。血流信号分级与患者生存状态相关性χ2=4.6424,P=0.0312。结论:CDFI显示乳腺癌患者肿瘤血流信号分级与NPI相关,血流信号分级与患者生存状态相关。

Purpose To explore the correlation between intratumoral blood flow assessed by color Doppler ultrasonography and the Nottingham Prognostic Index in patients with breast carcinoma.Materials and Methods Color Doppler flow imaging（CDFI）of 73cases of breast infiltrative ductal carcinoma was reviewed to evaluate the tumor vascular pattern,which was divided into four grades（0-3grade）according to the CDF I grade.Pathologic results were reviewed to evaluate the size of tumor,lymph node status and histological grade.The Nottingham Prognostic Index was calculated using the equation NPI=0.2xtumor size（cm）＋ grade（Ⅰ-Ⅲ）＋lymph node score（1-3）.The NPI was typically stratified into three major groups-NPI〈3.4,NPI 3.4-5.4,and NPI〉5.4.All patients enrolled were followed-up.Results The cases of NPI〈3.4,3.4-5.4,〉5.4with 0grade flow signal were 9,3and 1respectively.The cases with 1grade flow signal were 5,5and 4;the cases with 2grade flow signal were 4,11and 9,and the cases with 3grade flow signal were 1,8and 13,respectively.There was correlation between NPI and blood flow grades with rank correlation test（r= 0.487 28,P〈0.000 1）.Follow-up results：Patients with Blood flow signal 0and 1grade assessed by pre-operative CDFI were all healthily survived after surgery;1case with grade 2 blood flow signal was found bone metastasis and the other was dead;among the patients with the pre-operative blood flow signals of grade 3,one patient suffered from lung metastasis and 3patients died.Blood flow signal manifested by CDF I was related with surviving state（χ2= 4.642 4,P=0.031 2）.Conclusion Blood flow within the tumor detected by color Doppler flow imaging has a close relationship with the Nottingham Prognostic Index and survival of patients with breast carcinoma.