乳腺黏液癌超声表现与ER、HER-2、P53的对照研究

Correlation of sonographic features of mucinous carcinoma of breast with estrogen receptor(ER),CerbB-2 and P53

目的:探讨乳腺黏液癌超声声像图表现与免疫组织化学(免疫组化)指标表达的相关性。方法:对22例患者共23个乳腺黏液癌肿块的超声图像特征及免疫组化情况进行对照分析。结果:全部病灶中单纯型15个(65.22%),其中富细胞型7个(46.67%),少细胞型8个(53.33%),混合型8个(34.78%)。全部病灶ER、HER-2、P53阳性率分别为86.96%(20/23)、17.39%(4/23)、17.39%(4/23)。单纯型病灶的ER、HER-2、P53阳性率分别为80.00%(12/15)、13.33%(2/15)、20.00%(3/15),其中富细胞型的ER、HER-2、P53阳性率分别为100.00%(7/7)、14.28%(1/7)、28.57%(2/7),少细胞型ER、HER-2、P53阳性率分别为62.50%(5/8)、12.50%(1/8)、12.50%(1/8),混合型病灶的ER、HER-2、P53阳性率分别为100.00%(8/8)、25.00%(2/8)、12.50%(1/8)。全部病例的超声声像图表现为肿块,肿块边缘不规整者9个(39.13%);内部回声为等回声者13个(56.52%),低回声者10个(43.48%);内部回声不均匀者9个(39.13%);后方回声增强者15个(65.22%);BI-RADS分级为III级的9个(39.13%)、IV～V级的14个(60.87%)。所有肿块中,等回声肿块比低回声肿块有较高的ER阳性率表达,差异有统计学意义(P<0.05);单纯型肿块中,等回声肿块比低回声肿块有较高的ER阳性率表达,差异有统计学意义(P<0.05)。所有肿块中,内部回声不均匀肿块比内部回声均匀肿块有较高的HER-2阳性率表达,差异有统计学意义(P<0.05);单纯型肿块中,内部回声不均匀肿块比内部回声均匀肿块有较高的HER-2阳性率表达,差异有统计学意义(P<0.05)。结论:乳腺黏液癌超声表现与ER及HER-2的表达存在一定相关性,通过超声检查,可提示黏液癌的生物学行为,从而对乳腺黏液癌患者及高危妇女在早期诊断、治疗及预测预后方面提供一定的帮助。

Objective:To explore the relationship between the appearance of ultrasonogrphic features and estrogen receptor(ER),CerbB-2 and P53 in mucinous carcinoma of the breast,and evaluate the possibility of predicting the expression of ER,HER-2,P53 in mucinous carcinoma of the breast by means of ultrasonography.Methods:A total of 22 patients with 23 masses of the breast pathologically confirmed to be mucinous carcinoma were involved in this study.Expressions of ER,HER-2,P53 in the mastectomy specimens were determined by immunohistochemical staining technique.The correlation between the ultrasonographic features and ER,HER-2,P53 positive expression was analyzed.Results:There were 15(65.2%) were pure type among 23 masses,including 7(46.7%) cellular variants and 8(53.3%) hypocellular variants.The positive rate of ER,HER-2 and P53 of all masses was 87.0%(20/23),17.4%(4/23),17.4%(4/23) respectively.For the pure type,the positive rate was 80.0%(12/15),13.3%(2/15),20.0%(3/15)respectively.For the mixed type,the positive rate was 100.0%(8/8),25.0%(2/8),12.5%(1/8) respectively.The cellular variants was 100.0%(7/7),14.3%(1/7),28.6%(2/7)respectively and the hypocellular variants was 62.5%(5/8),12.5%(1/8),12.5%(1/8) respectively.On US examination,all 22 cases presented as mass.9(39.1%) of 23 masses showed ill-defined margin,13(56.5%) showed isoechoic,10(43.5%) showed hypoechoic,9(39.1%) showed nonhomogeneous echogenicity,15(65.2%) showed distal enhancement,9(39.1%) masses were classified as BI-RADS Ⅲ,15(60.9%) as BI-RADS Ⅳ-V.ER positive rate in masses which showed isoechoic was higher than that showed hypoechoic,HER-2 postive rate in masses which showed nonhomogeneous echogenicity was higher than that showed homogeneous echogenicity(P<0.05).Conclusion:There is definite correlation between the ultrasonographic featuers and the expression of ER,HER-2,P53 in mucinous carcinoma.Ultrasonographic featuers may help cilnical diagonosis,clinical therapy and prognosis evaluation of mucinous breast carcinoma.