乳腺导管内癌微浸润癌分子生物标志物的表达及其与超声表现的相关性

Expressions of biomarkers in breast ductal carcinoma in situ(DCIS) and DCIS with microinvasion(DCIS-Mi)and their relationship with sonographic features

目的 :探讨乳腺导管内癌(ductal carcinoma in situ,DCIS)与导管内癌伴微浸润(ductal carcinoma in situ with microinvasion,DCIS-Mi)间的分子生物学表达差异,并分析其与超声征象间的相关性。方法:回顾性分析199例DCIS患者的术前完整超声影像资料及可供分析的雌激素受体、孕激素受体、人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)、Ki-67指数等免疫组织化学指标,比较2组间分子生物学表达的差异,并探讨其与患者超声表现间的相关性。结果:199例患者中,DCIS为123例(61.8%),DCIS-Mi为76例(38.2%)。DCIS组与DCIS-Mi组间的雌激素受体、孕激素受体表达无统计学差异(P>0.05),而DCIS-Mi组的HER2阳性率及Ki-67指数均高于DCIS组(P<0.05)。2组病灶的各超声征象中,微钙化的存在与HER2阳性表达相关,而肿块的最大径及Adler血供分级与Ki-67指数高表达相关(P<0.05)。结论:DCIS-Mi患者较DCIS患者在分子生物学表达方面预后更差,而部分超声征象与DCIS及DCIS-Mi预后差的分子生物学表达间存在相关性。

Objectives： To study the differences between expressions of biomarkers in breast ductal carcinoma in situ （DCIS） and in breast DCIS with mieroinvasion （DCIS-Mi） and analyze their correlation with sonographie features. Methods： A total of 199 patients with comprehensive data were enrolled. Biomarkers including estrogen receptor （ER）, progesterone receptor （PR）, human epidermal growth factor receptor 2 （HER2） and Ki-67 index, as well as preoperative ultrasonographic imaging data were analyzed retrospectively. Differences in expressions of biomarkers mentioned above between DCIS and DCIS-Mi were analyzed. Correlations of expressions of biomarkers with sonographic features were evalua-ted. Results： Pathologic results demonstrated 123 cases of DCIS and 76 cases of DCIS-Mi. There was no significant difference in ER, PR expression between DCIS and DCIS-Mi （P〉0.05）. DCIS-Mi had a higher positive expression rate of HER2 and a higher expression of Ki-67 index than those in DCIS （P〈0.05）. Furthermore, presence of microealcifieation on sonographie features had correlation with HER2 positive expression, while larger tumor size and higher Adler grade of blood flow had significant correlation with high Ki-67 expression （P〈0.05）. Conclusions： Compared with DCIS, DCIS-Mi has more biomarkers of poor prognosis, and some sonographic features are associated with these biomarkers.