不同分子分型乳腺癌超声造影灌注特征的分析研究

Analytical research of CEUS perfusion characteristics of breast cancers with different molecular typing

目的:探讨分析不同分子分型乳腺癌超声造影(CEUS)定性灌注特征的差异性。方法:收集就诊于医院经穿刺活检或手术病理证实的87例(87个肿块)乳腺癌患者,参照病理结果分子分型,将其分为Luminal A型组(Luminal A组,27例)、Luminal B型组(Luminal B组,29例)、Erb-B2过表达型组(Erb-B2组,14例)和Basal-like型组(Basal-like组,17例)。所有患者均行常规超声及CEUS检查,观察并记录肿块CEUS声像图特征,比较CEUS灌注特征在不同分子分型乳腺癌间的差异。结果:Erb-B2组患者乳腺癌肿块大小高于其他三组,与Luminal A组和Luminal B组比较差异有统计学意义(t=-3.182,t=-2.992;P<0.05)。不同类型乳腺癌的内部灌注缺损、造影后肿块边界及穿入血管或放射状增强3个CEUS灌注特征不同,其差异有统计学意义(x^(2)=8.807,x^(2)=8.097,x^(2)=8.531;P<0.05);Basal-like组乳腺癌多表现为增强后边界清晰,Luminal A组和Luminal B组乳腺癌多见穿入血管或放射状增强,Erb-B2组乳腺癌多见内部灌注缺损。结论:不同分子分型乳腺癌在CEUS灌注特征上有所不同,可在术前为乳腺癌分子分型诊断提供新的依据。

Objective:To explore the difference of qualitative perfusion characteristics of contrast-enhanced ultrasound(CEUS)of breast cancers with different molecular typing.Methods:87 patients with breast cancer(87 masses)who admitted to hospital and were confirmed by biopsy or surgical pathology were selected,and they were divided into Luminal A type group(Luminal A group,27 cases),Luminal B type group(Luminal B group,29 cases),Erb-B2 overexpression group(Erb-B2 group,14 cases)and Basal-like type group(Basal-like group,17 cases).All patients underwent routine ultrasound examination and CEUS examination,and the CEUS sonographic features of the lump were observed and recorded.And then,the difference of CEUS perfusion characteristics among different breast cancers with different molecular typing.Results:The lump size of breast cancer in the Erb-B2 overexpression group was higher than that of the other three groups,which was significant different from that of Luminal A group and Luminal B group(t=-3.182,t=-2.992,P<0.05).The differences of three CEUS perfusion characteristics,which included the defect of internal perfusion,the boundary of the lump after angiography,and the penetration of blood vessels or the radial enhancement,of different molecular typing of breast cancer were significant(x^(2)=8.807,x^(2)=8.097,x^(2)=8.531,P<0.05).The most of breast cancer of Basal-like group showed clear boundaries after enhancement,and the breast cancers of Luminal A group and Luminal B group often penetrated into the blood vessel or were radial enhancement,and the breast cancer of Erb-B2 overexpression group more often showed the defects of internal perfusion.Conclusion:The breast cancers with different molecular typing have difference on CEUS perfusion characteristics,which can provide new basis for the diagnosis of molecular typing of breast cancer before surgery.