影响乳腺癌体积倍增时间的相关因素

Analysis of Correlated Factors Affecting Tumor Volume Doubling Time of Breast Cancer

目的：使用三维超声技术（30一US）测量乳腺癌体积，计算其体积倍增时间（TVDT），探讨TvDT的影响因素。方法：使用3D—US测量超声判断为BI—RADS—US4A的乳腺肿块的体积，筛选接受≥2次3D—US检查（间隔≥3个月），期间未进行医学干预的乳腺癌患者纳入研究。计算TVDT，多重线性回归分析影响乳腺癌TVDT的因素。结果：共入选69例患者，乳腺癌TVDT为66～521d，平均（185±126）d。（1）比较各乳腺癌肿块形态、有无边缘不光整、毛刺征、周边高回声晕、微钙化、后方回声特征，TVDT差异无统计学意义（均P〉0．05）；（2）比较各年龄分组、腋窝淋巴结转移情况、组织学分级、NPI评分分组，TVDT差异有统计学意义（均P〈0．05）。但TvDT因月经情况、乳腺癌家族史、病理类型的差异无显著性；（3）比较乳腺癌不同ER、PR、Ki-67表达、乳腺癌分子分型，TVDT差异有统计学性，但TVDT因HER2不同表达差异无显著性；（4）多因素分析显示影响乳腺癌TVDT的因素有NPI评分、腋窝淋巴结转移、Ki-67、乳腺癌分子分型。结论：乳腺癌TvDT与患者NPI评分、腋窝淋巴结转移、Ki-67及乳腺癌分子分型显著相关，乳腺癌分子分型中三阴型乳腺癌生长最快。

Objective To measure volume of breast cancer, calculate tumor volume doubling time （TVDT）, and analyze the correlated factors affecting TVDT using three-dimensional ultrasound （3D-US）. Methods We applied 3D-US to measure the volume of breast cancer of BI-RADS-US 4A classified by conventional ultrasound. The breast cancer case scanned by 3D-US at least twice （the interval is 3 months at least） without any medical intervention were included in the study. We calculated TVDT according to the formula, and analyzed the affecting factors of TVDT using multiple linear regression. Results Sixty-nine cases were enrolled in the study. The TVDT of breast cancer were from 66 to 521 days, in an average of 185±126 days and the median time of 164 days. We found that： ①there were no statistics significances in TVDT between different breast cancer pattern, smoothing border lines, speculated sign, hyperechoic halo, microcalcification and different rear echo （P 〉 0.05）. ② TVDT of different age groups, lymph node metastasis, pathological grade and NPI score were significantly different （P 〈 0.05）, while menstrual cycle, family history of breast cancer and molecular typing showed no difference （P 〉 0.05）. ③ TVDT of patients with different expression of ER, PR and Ki-67, molecular typing showed statistically difference （P 〈 0.05）, but there was no significant difference between different level of HER2 （P 〉0.05）.④ multi-factor analysis showed that the NPI score, lymph node metastasis, Ki-67 and molecular typing of breast cancer were relative factors in TTDT （P 〈 0.05）. Conclusions The NPI score, lymph node metastasis, Ki-67 and molecular typing significantly correlate with TVDT of breast cancer. Triple-negative breast cancer in molecular typing has the fastest growth rate.