探讨超声弹性成像参数与乳腺癌腋窝淋巴结转移及Ki-67表达的相关性

Correlation of ultrasonic elastography parameters with axillary lymph node metastasis and the expression of Ki-67 in breast cancer

目的探讨乳腺癌病灶超声弹性成像(UE)中的硬度评分、UE图和二维超声(2D-US)图两种成像模式中的面积比与腋窝淋巴结转移及Ki-67表达有无相关性。方法收集经病理组织学证实的乳腺癌患者60例,共60个病灶。对所有患者手术前均行常规超声及UE检查,判断病灶硬度评分,分别测量病灶在UE图与2D-US中的面积,系统软件自动计算面积比值。术后采用免疫组织化学方法测定Ki-67的表达。分析乳腺癌病灶的UE硬度评分、UE图和2D-US图两种成像模式中的面积比与腋窝淋巴结转移及Ki-67表达的相关性。结果乳腺癌病灶UE硬度评分与腋窝淋巴结转移和Ki-67表达均无相关性(P均>0.05)。乳腺癌病灶在UE与2D-US两种不同成像模式中测量的面积比与腋窝淋巴结转移无相关性(P>0.05),与Ki-67表达呈正相关(r=0.368,P=0.004)。结论 UE硬度评分不能作为乳腺癌预后判断的指标。UE与2D-US两种不同成像模式测量的乳腺癌病灶面积比不能预示乳腺癌患者腋窝淋巴结的转移情况,但有助于了解乳腺癌患者癌细胞增殖情况和判断患者预后。

Objective To explore the correlation of the ultrasonic elastography（UE） scores and the ratios of traced areas in UE versus two-dimensional ultrasound（2D-US） with axillary lymph node metastasis and the expression of Ki-67 in breast cancer.Methods Sixty breast cancer patients with single lesion underwent conventional ultrasound and UE before operation.The lesions were evaluated by elastic scores,and the traced areas of the lesions were measured respectively on UE and 2D-US images,while the ratios of traced areas were automatically calculated by system software.All the patients were confirmed pathologically,and the expressions of Ki-67 were detected by immunohistochemistry technique after operation.The correlation of UE scores and the ratios of traced areas in UE versus 2D-US with axillary lymph node metastasis and the expression of Ki-67 were analyzed.Results No statistical correlation was found between the elastic scores with axillary lymph node metastasis or Ki-67 expression in breast cancer（both P0.05）,nor between the ratios of traced areas in UE versus 2D-US and axillary lymph node metastasis（P0.05）,whereas positive correlation was found between the ratios of traced areas in UE versus 2D-US and Ki-67 expression（r=0.368,P=0.004）.Conclusion The elastic score can not be used as the indicator of prognosis judgment of breast cancer.The ratios of traced areas in UE versus 2D-US can not prognosticate axillary lymph node metastasis,but helps to evaluate the proliferation of breast cancer cells and the prognosis of the patients.