乳腺癌超声毛刺征部位胶原纤维增生与预后因素的关系

Relationship between collagen fibrosis of ultrasound spiculations and prognostic factors in patients with breast cancer

目的探讨乳腺癌超声毛刺征部位胶原纤维增生程度与预后因素间的关系。方法收集经病理证实的60例乳腺癌,术前超声检查证实肿块周边毛刺征,并在超声引导下于毛刺处穿刺活检,根据胶原纤维组织增生程度将其分为胶原纤维轻度、中度和重度增生。分析乳腺癌超声毛刺征处胶原纤维组织增生程度与预后因素(癌灶大小、组织学分级、淋巴结转移和免疫组化分子标志物表达)之间的关系。结果乳腺癌毛刺处胶原纤维组织轻度、中度与重度增生患者间,组织学分级、癌灶大小、淋巴结转移差异均有统计学意义(P均<0.05);重度增生患者肿瘤组织学分级较高、肿瘤较大、淋巴结转移者较多。乳腺癌毛刺处纤维组织轻度、中度与重度增生患者之间,雌激素受体(ER)及人表皮生长因子受体-2(HER-2/neu)表达差异有统计学意义(P均<0.05),重度增生患者ER表达低,HER-2/neu表达高;而孕激素受体(PR)、Ki-67表达差异均无统计学意义(P均>0.05)。结论乳腺癌毛刺处胶原纤维增生程度与预后密切相关,胶原纤维增生严重提示乳腺癌预后较差。

Objective To investigate the relationship of the extent of collagen fibrosis in ultrasound spiculation sign of breast cancer and the prognostic factors.Methods Totally 60 patients with pathologically confirmed breast cancer were enrolled.Spiculation sign around the tumor was found with pre-operational ultrasound in all 60 patients.Ultrasound-guided biopsy was performed to obtain the tissue of spiculation sign area.The sections were routinely stained to observe according to the degree of collagen fibrosis,and hyperplasia of spiculation tissue were divided into mild,moderate and severe degrees.Then the relationship of collagen fibroplasia of spiculation sign and prognostic factors(tumor size,histological grade,lymph node metastasis and immunohistochemical molecular markers)of breast cancer were analyzed.Results There were significant differences of histological grade,tumor size and lymph node metastasis among patients with mild,moderate and severe hyperplasia of spiculation sign area(all P<0.05).In patients with severe hyperplasia,higher tumor histological grade,larger size of tumor and more lymph node metastasis were found.There were significant differences in the expressions of estrogen receptor(ER)and human epithelial growth receptor-2(HER-2/neu)among patients with mild,moderate and severe hyperplasia of spiculation sign area(both P <0.05).In patients with severe hyperplasia,low expression of ER and high expression of HER-2/neu were found.There was no significant difference of the expression of progesterone receptor(PR)nor Ki-67(both P>0.05).Conclusion The degree of collagen hyperplasia of spiculation sign area of breast cancer is closely related to patients’ prognosis.Severe hyperplasia of ultrasound spiculation sign area can be used to indicate poor prognosis of patient with breast cancer.