三维容积超声VOCAL参数与肿块型乳腺浸润性导管癌病理分级的相关性研究

Correlation between three-dimensional volume ultrasound VOCAL parameters and pathological grading of mass type breast invasive ductal carcinoma

目的传统二维超声及彩色多普勒血流成像对不同病理级别的肿瘤间差异与否未进行进一步分析。文中探讨三维容积超声VOCAL参数与肿块型乳腺浸润性导管癌病理分级的相关性。方法回顾性分析2014年3月至2016年2月就诊于新疆医科大学第一附属医院且经病理证实具有病理分级的106例乳腺结节患者。术前行三维容积超声检查,采用GE Logiq E9自带VOCAL软件对病灶进行分析,获取能量直方图。对导管原位癌、浸润性导管癌I级、浸润性导管癌II级、浸润性导管癌III级及纤维腺瘤的平均灰阶、平均能量、血管指数、血流血管指数的差异进行分析。结果平均灰阶在导管原位癌、纤维腺瘤以及IDC I级间两两比较,差异无统计学意义(P>0.05),其他病理级别间两两比较差异均具有统计学意义(P<0.05);平均能量在各病理分级超声参数间两两比较,差异均具有统计学意义(P<0.05);血管指数、血流血管指数在导管原位癌与纤维腺瘤间差异无统计学意义(P>0.05),其他病理级别间两两间比较差异均具有统计学意义(P<0.05)。结论三维容积超声VOCAL参数平均灰阶、平均能量、血管指数、血流血管指数可以反映肿块型不同病理分级乳腺结节内部的灰阶等级和血流灌注情况,在术前初步预测病理分级,为肿块型乳腺浸润性导管癌癌术前评估及个体化治疗方案的制定提供客观依据。

Objective The article was to discuss the correlation between threedimensional volume ultrasound VOCAL parameters and pathological grading of mass type breast invasive ductal carcinoma. Methods 106 breast nodule patients admitted in our hospital who were pathologically confirmed with histological grading from March 2014 to February 2016 were included in the study. The patients underwent threedimensional volume ultrasound preoperatively. Vocal system in GE LOGIQ E9 was used in lesion analysis to obtain energy histograms：average gray scale （MG）, average energy （MP）, vascular index （ R） , blood flow index （ VFI） . Analysis was made in the difference among MG, MP, R and VFI of ductal carcinoma in situ, invasive ductal carcinoma grade Ⅰ, invasive ductal carcinoma grade Ⅱ, invasive ductal carcinoma grade Ⅲ and fibroadenoma. Results No significant difference was found in MG of ductal carcinoma in situ and IDC Ⅰ, fibroadenoma and ductal carcinoma in situ, fibroadenoma and IDC Ⅰ（P〉0.05）, but the difference was statistically significant between other pathological levels （P〈0.05）. Significant difference was found in MP between pathological levels （ P〈0.05） . No significant difference was found in R and VFI between ductal carcinoma in situ and fibroadenoma（ P〉0.05） , but the difference was statistically significant between other pathological levels （ P〈0.05） . Conclusion Threedimensional volume ultrasonic VOCAL parameters of MG、MP、R、VFI can reflect grayscale levels and blood flow perfusion in mass type breast nodules of different pathological level, and predict the pathological grading before operation, which provides objective evidence for the evaluation of mass type breast invasive ductal carcinoma and the development of individualized treatment plan.