乳腺癌Annexin A7表达与超声影像学表现的关系及二者联合评估腋窝淋巴结转移的价值

Correlation of Annexin A7 Expression with Ultrasonic Appearance in Breast Cancer Patients and Its Clinical Value for Diagnosing Axillary Lymphatic Metastases

目的探讨乳腺癌患者Annexin A7表达水平与腋窝淋巴结转移的关系及其与超声影像学表现的关系,评估二者联合诊断患者腋窝淋巴结转移的临床价值。方法研究纳入2013年1月—2014年10月在我院确诊并进行治疗的乳腺癌患者49例,应用彩色多普勒超声诊断仪观察原发灶和腋窝淋巴结的相应指标,免疫组织化学分析乳腺癌组织和对应癌周正常组织中Annexin A7的表达变化情况,ROC曲线评估Annexin A7表达联合超声影像学指标诊断患者腋窝淋巴结转移的临床价值。结果乳腺癌组织中的Annexin A7阳性表达例数较高,存在腋窝淋巴结转移的患者中,Annexin A7阳性表达比例较高。原发灶位置、原发灶最大直径、原发灶血流分级、淋巴结L/T、淋巴结皮质厚度以及血流分布类型与患者的腋窝淋巴结转移有关(P<0.05)。原发灶位置、最大直径、淋巴结L/T、淋巴结血流分布类型以及淋巴结皮质厚度不同的患者,其Annexin A7表达有所不同(P<0.05)。ROC曲线表明,超声影像学指标联合Annexin A7诊断乳腺癌腋窝淋巴结转移的临床价值更高。结论 AnnexinA7表达与乳腺癌的发生和腋窝淋巴结转移有关,Annexin A7表达与超声影像学表现有一定关联,可用于腋窝淋巴结转移的联合诊断。

OBJECTIVE To investigate the correlation of Annexin A7 expression with lymphatic metastases and ultrasonic appearance in breast cancer patients.METHOD 49 patients with breast cancer were included in the study.Ultrasonic appearance of all cases were detected by color Doppler ultrasonic diagnostic apparatus.Immunohistochemical assay was performed to show the expression changes of Annexin A7 between breast cancer tissue and matched normal tissue.RESULT Compared with normal tissue,in cancer tissue,Annexin A7 expression was higher dramatically,meanwhile,increasing expression of Annexin A7 was also observed in patients with axillary lymphatic metastases.In ultrasonic appearance,the primary tumor site,maximal scale of primary tumor site,blood flow richness,L/T of lymph node,cortical thickness of lymph node and blood distribution in lymph node were related to the axillary lymphatic metastasis.Moreover,the expression of Annexin A7 was associated with above ultrasonic parameters excepting blood flow richness.ROC curves showed that Annexin A7 combining with ultrasonic parameters could diagnose axillary lymphatic metastases more effectively for breast cancer patients.CONCLUSION There was definite correlation between Annexin A7 expression and the ultrasonic appearance in breast cancer patients or occurrence of axillary lymphatic metastases.Annexin A7 could be used in combination with ultrasonic appearance to diagnose axillary lymphatic metastases.