SWE-Emax与乳腺癌分子分型及远期预后的关系研究

Correlation between SWE-Emax and molecular typing as well as long-term prognosis of patients with breast cancer

目的探讨剪切波弹性成像最大弹性(SWE-Emax)值对乳腺癌分子分型及远期预后的关系,为后续预后评估及治疗方案制定提供更多依据。方法选取2014年7月至2018年7月收治的乳腺癌患者80例,术前采用SWE检查86个病灶,分析SWE-Emax与肿物直径、组织分级、免疫组化指标及分子亚型间相关性,同时采用多因素回归分析法评价SWE-Emax可能影响因素。结果乳腺癌患者肿物直径与SWE-Emax值呈正相关(P<0.05);HER-2阳性和Ki-67阳性乳腺癌患者肿块SWE-Emax值均显著大于阴性者(P<0.05);单因素方差分析显示不同分子亚型乳腺癌患者间肿物SWE-Emax值差异有显著性(P<0.05);多元线性回归方程代入肿物直径、HER-2阳性、Ki-67阳性及分子亚型,提示肿物直径和HER-2阳性表达是影响乳腺癌患者肿块SWE-Emax值重要因素,且肿物直径影响最大(P<0.05)。结论乳腺癌患者肿物SWE-Emax值与HER-2、Ki-67表达具有相关性,临床预后差分子亚型乳腺癌患者肿物SWE-Emax值较高;SWE可在一定程度上为乳腺癌患者临床预后评价及治疗方案制定提供依据。

Objective To investigate the correlation between SWE-Emax and molecular typing as well as long-term prognosis of patients with breast cancer,so as to provide more evidence for prognosis assessment and treatment plan formulation.Methods Eighty patients with breast cancer who were admitted and treated in our hospital from July 2014 to July 2018 were enrolled in the study,whose 86 lesions were examined by SWE before operation.The correlation between SWE-Emax and tumor diameter,tissue grade,immunohistochemical indexes as well as molecular subtype was analyzed,meanwhile,the possible influencing factors of SWE-Emax were evaluated by multivariate regression analysis.Results The diameter of tumor was positively correlated with SWE-Emax value in patients with breast cancer patients(P<0.05).The SWE-Emax values in breast cancer patients with positive HER-2 and positive Ki-67 were significantly higher than those of patients with negative ones(P<0.05).Univariate analysis of variance showed that there were significant differences in SWE-Emax values among the breast cancer patients with different molecular subtypes(P<0.05).The multivariate linear regression equation and multivariate linear regression equation showed that lesion diameter,positive expressions of HER-2 and Ki-67,and molecular subtypes of breast cancer were the important factors affecting the SWE-Emax values in patients with breast cancer,and the influencing effects of the lesion diameter of breast cancer were the greatest(P<0.05).Conclusion The SWE-Emax values of tumor in patients with breast cancer are correlated with the expression levels of HER-2 and Ki-67,and the SWE-Emax values in breast cancer patients with the molecular subtypes of poor clinical prognosis are higher,therefor,SWE may provide the basis for clinical prognosis evaluation and treatment plan formulation in patients with breast cancer patients to a certain extent.