不同雄激素受体表达的三阴性乳腺癌患者的超声表现及其临床意义

Ultrasonographic findings and clinical significance of triple negative breast cancer patients with different androgen receptor expressions

目的 探讨三阴性乳腺癌(TNBC)患者的超声表现与雄激素受体(AR)表达的关系,为TNBC的患者的临床诊疗提供更准确的影像学参考。方法 回顾性分析127例病理组织学确诊为TNBC患者的超声声像图,根据患者病理结果分为AR阳性组与AR阴性组,并进行组间对比分析其生物学表达情况。结果 127例TNBC患者AR阳性组与阴性组比较,肿瘤的形态特征、直径大小及肿块纵横比之间无明显相关性(P>0.05),但是在肿块后方回声、边缘边界、微钙化、晕环、淋巴结肿大以及血管弹性成像等方面,31例AR阴性组中患者27例发生肿块后方回声衰减,远远多于阳性组(4/13)、7例阴性组中患者5例观察到边缘毛刺,3个阴性组患者全部可以观察到晕环(P<0.05)。超声表现中探及微钙化及丰富的血流信号时,也常提示AR的表达呈阴性(P<0.05);发生淋巴结肿大、淋巴结转移时,AR常为阴性表达(P<0.05)。结论 TNBC患者中AR的表达与超声声像图的表现具有一定的相关性,AR表达阴性的患者肿瘤侵袭性强、恶性程度高,且发生远处转移及复发的风险增大。

Objective To investigate the relationship between ultrasound manifestations and androgen receptor(AR)expression in patients with triple-negative breast cancer(TNBC),and to provide more accurate imaging reference for clinical diagnosis and treatment of TNBC.Methods The ultrasound images of 127 patients with histopathological diagnosis of TNBC were retrospectively analyzed.According to the pathological results,the patients were divided into AR positive group and AR negative group,and the biological expression was compared between the groups.Results There was no significant correlation between tumor morphology,diameter and mass aspect ratio(P>0.05)in the AR positive group and the negative group of 127 TNBC patients.However,there was no significant correlation between tumor morphology,tumor diameter and mass aspect ratio(P>0.05).In the 31 patients with AR negative group,27 patients had echo attenuation behind the mass,which was much more than that in the positive group(4/13).In the 7 patients with AR negative group,5 patients had edge burr,and halo could be observed in all the 3 negative groups(P<0.05).When microcalcification and rich blood flow signal were detected in ultrasound manifestations,AR expression was often negative(P<0.05).When lymphadenopathy and lymph node metastasis occurred,AR expression was often negative(P<0.05).Conclusion The expression of AR in TNBC patients has a certain correlation with the appearance of ultrasonography.Patients with negative AR expression are more aggressive and malignant,and the risk of distant metastasis and recurrence is increased.