三维超声冠状面汇聚征在评估乳腺癌预后中的价值

Value of retraction phenomenon at three-dimensional ultrasonography in assessment of prognostic factors in breast cancer

目的 探讨三维超声冠状面汇聚征在评估乳腺癌预后中的价值.方法 对66例乳腺癌患者术前行三维超声检查,观察病灶在冠状面上的汇聚征显示率,并与肿块直径、病理级别、淋巴结状态以及雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子-2（CerbB-2）、p53表达作比较,统计分析汇聚征与预后因子的相关性.结果 乳腺癌的汇聚征显示率与肿瘤直径、病理级别以及ER、PR表达有关.与无汇聚征组相比,有汇聚征组的肿瘤直径多≤2 cm（73.7％对46.4％,P＜0.05）,病理级别常为Ⅱ级（88.2％对42.9％,P＜0.01）,且ER、PR的阳性率较高（86.8％对64.3％,P＜0.05；81.6％对57.1％,P＜0.05）.两组的CerbB-2、p53表达、淋巴结状态之间差异无统计学意义（P＞0.05）.结论 三维超声汇聚征显示情况有助于评估乳腺癌预后,从而指导临床治疗方案的制定.

Objective To investigate the value of retraction phenomenon in coronal plane at threedimensional ultrasonography（3D-US） in preoperative assessment of prognostic factors in breast cancer.Methods Surgical resection specimens of 66 malignant breast lesions in 66 women who had undergone 3D-US were included.The presence of the retraction phenomenon in the coronal plane was evaluated.Pathologic prognostic factors,including tumor size,histologic grade,lymph node status,estrogen receptor （ER） and progesterone receptor （PR） status,and human epidermal growth factor receptor 2 （Cerb-B2） and p53 expression were determined.Correlation of the retraction phenomenon and prognostic factors was analyzed.Results The retraction phenomenon was correlated to the tumor size,histologic grade,and estrogen and progesterone receptor status.Compared with the breast cancer without the retraction phenomenon,the tumor foci with the retraction phenomenon were more likely to show a smaller diameter less than 2 cm （73.7％ vs 46.4％,P ＜0.05）,a lower histologic grade with grade Ⅱ （88.2％ vs 42.9％,P ＜0.01）,and a higher positive rate of ER and PR （86.8 ％ vs 64.3 ％,P ＜0.05;81.6 ％ vs 57.1％,P ＜0.05）.The lymph node status and the expression of the CerB-2 and p53 in the two groups had no significant difference （P ＞0.05）.Conclusions The retraction phenomenon in the coronal plane of three-dimensional US may be useful in the noninvasive prediction of prognostic factors of breast cancers.