三阴性乳腺癌超声征象与P53的相关性

Correlation Between Ultrasonic Features of Triple-negative Breast Cancer and P53

目的比较三阴性乳腺癌(TNBC)与非三阴性乳腺癌(NTNBC)的超声特征,以提高术前超声对TNBC的诊断能力,并探讨TNBC超声特征与P53的相关性。资料与方法回顾性分析经手术病理确诊的452例乳腺癌,采用免疫组化法检测雌激素受体、孕激素受体、人表皮生长因子受体-2的表达情况,并分为TNBC组与NTNBC组,比较两组的超声征象特点,分析TNBC的超声征象与P53的相关性。结果 TNBC组超声声像图中肿块椭圆形、后方回声增强、内部血流Ⅱ～Ⅲ级病例的发生率(45.1%、38.0%、57.7%)高于NTNBC组(14.7%、20.7%、43.8%),差异均有统计学意义(P<0.05);TNBC组肿块边缘毛刺、内部微钙化的发生率(12.7%、25.4%)低于NTNBC组(35.7%、54.6%),差异均有统计学意义(P<0.05);两组肿块直径、纵横比比较,差异无统计学意义(P>0.05)。TNBC组的P53阳性表达率为64.8%,TNBC超声血流分级与P53表达呈正相关(r=0.325,P<0.05)。结论 TNBC的肿块形态、边缘、微钙化、后方回声等二维超声征象与NTNBC差异较大,肿块内部血流分级有助于诊断TNBC;TNBC的超声血流分级与P53表达相关。

Purpose To compare ultrasonic features of triple-negative breast cancer (TNBC) and non-triple-negative breast cancer (NTNBC) to improve diagnostic capabilities of preoperative ultrasound of TNBC, and to explore the correlation between TNBC ultrasonic features and P53. Materials and Methods Four hundred and fifty-two breast cancers confirmed through surgical pathology were retrospectively analyzed. Immunohistochemical method was taken to examine estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2) expression which were divided into TNBC group and NTNBC group. Ultrasonic sign features in the two groups were compared and correlation between TNBC ultrasonic signs and P53 was analyzed. Results Incidence rate of oval mass, posterior acoustic enhancement and internal blood flow graded Ⅱ-Ⅲ in ultrasonic images in TNBC group was 45.1%, 38.0% and 57.7%, respectively;which was higher than that in NTNBC group of 14.7%, 20.7% and 43.8%, respectively. The difference was of statistical significance ( P <0.05). Incidence rate of burrs on edges of the mass and internal micro-calcification in TNBC group was 12.7% and 25.4%, respectively;which was lower than the 35.7% and 54.6% in NTNBC group. The difference was of statistical significance ( P <0.05). Regarding comparison of tumor diameter and latitude, the difference was of no statistical significance ( P >0.05). P53 positive expression rate in TNBC group was 64.8%. TNBC ultrasonic blood flow classification was in positive correlation to P53 expression ( r =0.325, P <0.05). Conclusion Tumor morphology, edges, micro-calcification, posterior echoes and other two dimensional signs of TNBC were of great difference with NTNBC. Tumor internal blood flow classification could assist with TNBC diagnosis. Ultrasonic blood flow classification of TNBC is related to P53 expression.