剪切波弹性成像弹性模量值与乳腺癌临床病理及分子分型的关系

Correlations between Elastic Modulus Index Measured by Ultrasonic Shear Wave Elastography with Clinicopathology and Molecular Classification of Breast Cancer

目的探讨超声剪切波弹性成像(SWE)弹性模量值与乳腺癌临床病理的关系,并分析SWE弹性模量值在不同分子分型乳腺癌中的差异。方法选取2018年10月—2020年12月收治的93例女性乳腺癌(112个病灶)为研究对象。术前均行SWE检查,记录各病灶的病理特征及弹性模量最大值(E_(max))和平均值(E_(mean))。Pearson相关性分析E_(max)和E_(mean)值与乳腺癌不同分子分型及临床病理的关系。结果病理类型以浸润性导管癌最多,占比77.68%(87/112);分子分型以Luminal A型病灶最多,占比41.96%(47/112);三阴性乳腺癌和人表皮生长因子受体-2(HER-2)过表达型病灶的E_(max)、E_(mean)值均高于Luminal A型(P<0.05);不同组织学分级、肿瘤直径及HER-2表达乳腺癌病灶的E_(max)、E_(mean)值比较差异均有统计学意义(P<0.05,P<0.01)。E_(max)、E_(mean)值与分子分型、组织学分级、肿瘤直径、HER-2表达均呈显著正相关(P<0.05,P<0.01)。结论SWE中E_(max)、E_(mean)值均随乳腺癌分子分型的升高而增大,且上述弹性模量值与病灶组织学分级、肿瘤直径及HER-2表达水平均有一定关联,临床可将E_(max)、E_(mean)值作为诊治乳腺癌的重要参考指标。

Objective To investigate correlation between elastic modulus index(EI)measured by ultrasonic shear wave elastography(SWE)with clinicopathology of breast cancer(BC),and to analyze the differences of EI values measured by SWE in different molecular types of BC.Methods A total of 93 female BC patients(112 lesions)admitted between October 2018 and December 2020 were selected as research subjects.SWE examinations were all performed before operation,and the pathological characteristics of each lesion and the maximum elasticity(E_(max))and mean elasticity(E_(mean))of EI were recorded.Pearson correlation analysis was used to analyze correlations between E_(max) and E_(mean) values with different molecular types and clinicopathology of BC.Results Most pathological type was invasive ductal carcinoma,accounting for 77.68%(87/112).Luminal type A lesions were the most common in molecular classification,accounting for 41.96%(47/112).E_(max) and E_(mean) values in three-negative breast cancer and human epidermal growth factor receptor-2(HER-2)overexpression lesions were significantly higher than those in Luminal type A lesions(P<0.05).There were significant differences in E_(max) and E_(mean) values in breast cancer patients with different histological classifications,tumor diameters and HER-2 expressions(P<0.05,P<0.01).E_(max) and E_(mean) values were significantly positively correlated with molecular classification,histological classification,tumor diameter and HER-2 expression(P<0.05,P<0.01).Conclusion The E_(max) and E_(mean) values in SWE increase with increasing molecular classification of breast cancer.Moreover,the above EI values are related to histological classification of lesion,tumor diameter and HER-2 expression,and therefore E_(max) and E_(mean) can be used as important reference indexes for the diagnosis and treatment of patients with breast cancer.