早期乳腺导管内癌钼靶X线超声造影表现及与免疫组化HER-2 nm-23表达的关系

The Correlation Between Mammography and Contrast-Enhanced Ultrasonography and Immunohistochemical HER-2 and nm-23 Expression in Early Intraductal Breast Carcinoma

目的:探究早期乳腺导管内癌(DCIS)钼靶X线、超声造影(CUES)表现及与免疫组化HER-2、nm-23表达关系。方法:回顾性的选取2018年1月至2020年1月在我院收治的80例DCIS患者作为研究对象,均具钼靶X线、CUES图像资料及病理组织切片,免疫组化法检测HER-2、nm-23表达水平、收集患者影像学特征,并采用Spearman行相关性分析。结果:80例患者中,免疫组化检查HER-2高表达36例、HER-2低表达44例,nm-23高表达38例、nm-23低表达42例。HER-2高表达组血管分布异常、非向心性增强、高增强、非均匀增强占比及峰值强度(PI)均显著高于HER-2低表达组(P<0.05),且HER-2高表达组的时间强度峰值(TTP)显著低于HER-2低表达组(P<0.05);nm-23高表达组非放射性增强占比及TTP显著高于nm-23低表达组(P<0.05),而PI显著低于nm-23低表达组(P<0.05)。HER-2高表达与TTP均呈正相关(P<0.05),与PI呈高度负相关(P<0.05);nm-23高表达与TTP呈负相关(P<0.05),与PI呈正相关(P<0.05)。结论:钼靶X线、CUES特征与免疫组化HER-2、nm-23表达水平之间存在相关性,且血管分布异常、向心性增强、高增强、放射状增强及TTP较高而PI较低应怀疑为HER-2高表达,TTP较低、PI较高则应当怀疑nm-23高表达。

Objective:To explore the correlation between molybdenum target X-ray and CUES expression in early DCIS and immunohistochemical HER-2 and nm-23 expression.Methods:A total of 80 cases of DCIS patients admitted from January 2018 and January 2020 were retrospective selected as the research object.Expression levels of immunohistochemical HER-2 and nm-23 were detected and image data were collected,which were analyzed with Spearman.Results:Among the 80 patients,there were 36 cases with high expression of HER-2,44 cases with low expression of HER-2,38 cases with high expression of nm-23,and 42 cases with low expression of nm-23 by immunohistochemistry.Abnormal vascular distribution,non-centric enhancement,high enhancement,non-uniform enhancement,and PI in the high HER-2 expression group were significantly higher than those in the low HER-2 expression group(P<0.05),and TTP in the high HER-2 expression group was significantly lower than that in the low HER-2 expression group(P<0.05).The proportion of non-radioactive enhancement and TTP in the high expression group of nm-23 were significantly higher than those in the low expression group of nm-23(P<0.05),while PI was significantly lower than that in the low expression group of nm-23(P<0.05).High expression of HER-2 was positively correlated with TTP(P<0.05),and negatively correlated with PI(P<0.05).High expression of nm-23 was negatively correlated with TTP(P<0.05),and positively correlated with PI(P<0.05).Conclusion:The characteristics of moly target X-ray and CUES are correlated with the expression levels of immunohistochemical HER-2 and nm-23,and abnormal vascular distribution,enhanced centrality,high enhancement,radial enhancement,high TTP and low PI should be suspected to be high HER-2 expression,while low TTP and high PI should be suspected to be high nm-23 expression.