乳腺良恶结节超声与剪切波弹性成像参数的临床价值

Clinical value of shear wave ultrasound elastography indexes of benign and malignant breast nodules

目的对剪切波弹性成像各项指标的诊断效能进行优选排序,探究其与恶性结节分子分型的联系。方法选取2016年12月至2020年6月于我院就诊同时行超声检查和手术治疗的200例乳腺结节患者(良性、恶性各100例)为研究对象,对其二维超声、剪切波弹性成像和结节病理结果进行整理和分析。结果良/恶性结节患者的年龄、结节最大直径和SWE参数(Emax、Emin、Emean、Eratio、Esd)比较,差异均有统计学意义(P<0.05);Emax的AUC=0.998,Emean的AUC=0.990,Eratio的AUC=0.994;Luminal A-like型的直径和Emax最小,Her-2阳性(HR阳性)型的直径和Emax最大,差异有统计学意义(P=0.02,0.047);Her-2阳性(HR阳性)型Eratio最大,非Her-2阳性组的Eratio值均比其小,差异有统计学意义(P=0.036,0.012,0.035)。结论剪切波弹性成像参数在鉴别乳腺良恶性结节方面有较好的准确性同时其还同乳腺癌分子亚型有一定相关性,可为乳腺癌的预后提供一些初步的参考。

Objective To rank the diagnostic performance of various indexes of shear wave elastography,and to explore the relationship between them and the molecular classification of malignant nodules.Methods A total of 200 patients with breast nodules(100 benign and 100 malignant)treated in our hospital and underwent ultrasound examination and surgical treatment from December 2016 to June 2020 were selected.Two-dimensional ultrasound,shear wave elastography and nodule pathology were collected and analyzed.Results There were significant differences in age,maximum diameter of nodules and SWE indexes(Emax,Emin,Emean,Eratio,Esd)between the benign group and the malignant group(P<0.05).The AUC of Emax=0.998,AUC of Emean=0.990,Eratio AUC=0.994.The Luminal A-like type had the smallest diameter and Emax,while the Her-2 positive(HR-positive)type had the largest diameter and Emax,with statistically significant differences(P=0.020,0.047).The Her-2 positive(HR-positive)type had the largest Eratio,which was larger those of all the non-Her-2 positive,with statistically significant differences(P=0.036,0.012,0.035).Conclusion Shear wave elastography indexes have good accuracy in identifying benign and malignant breast nodules.They have a certain correlation with the molecular subtypes of breast cancer,which can provide preliminary references for the prognosis of breast cancer.