乳腺浸润性导管癌超声灰度直方图特征与HER-2表达的相关性

Correlation Between the Characteristics of Ultrasound Gray Histogram and HER-2 Expression in Invasive Ductal Carcinoma of Breast

目的探讨乳腺浸润性导管癌超声灰度直方图特征与人表皮生长因子受体-2(HER-2)表达的相关性。资料与方法回顾性分析湖北省肿瘤医院2018年9月—2020年12月经病理证实的乳腺浸润性导管癌患者共175例,分为HER-2阳性组(66例)和HER-2阴性组(109例);对所有病灶的超声图像作灰度直方图分析,分析病灶特征参数(包括均值、方差、偏度、峰度及第1、10、50、90、99百分位数)与HER-2阳性表达的相关性;比较HER-2阳性组和HER-2阴性组患者直方图参数的差异,计算诊断HER-2阳性表达的最佳阈值。结果方差、第90、99百分位数与HER-2阳性表达呈正相关(r=0.422、0.259、0.361,P均<0.05);HER-2阳性组的方差、第90、99百分位数明显高于HER-2阴性组,差异有统计学意义(t=6.114、3.440、5.073,P均<0.05);方差预测HER-2阳性表达的最佳诊断阈值为711.19,此时敏感度、特异度及受试者工作特征曲线下面积(AUC)分别为68.2%、70.6%和0.751。第90百分位数预测HER-2阳性表达的最佳诊断阈值为80.5,此时敏感度、特异度及AUC分别为56.1%、75.2%和0.654。第99百分位数预测HER-2阳性表达的最佳诊断阈值为129,此时敏感度、特异度及AUC分别为57.6%、84.4%和0.715。结论方差、第90、99百分位数与HER-2的表达有一定的相关性,可间接为乳腺浸润性导管癌患者的临床治疗及预后评估提供一定的参考价值。

Purpose To investigate the correlation between the characteristics of ultrasound gray histogram and the expression of human epidermal growth factor receptor-2(HER-2)in breast invasive ductal carcinoma.Materials and Methods 175 patients with invasive ductal carcinoma confirmed by pathology in Hubei cancer hospital from September 2018 to December 2020 were retrospectively analyzed.The patients were divided into HER-2 positive group(66 cases)and HER-2 negative group(109 cases).The ultrasonograms of all lesions were analyzed by gray histogram.The correlation between the characteristic parameters(including mean,variance,skewness,kurtosis and 1,10,50,90,99 percentiles)and HER-2 positive expression were analysed.The differences of histogram parameters between HER-2 positive group and HER-2 negative group were compared,and the best threshold for the diagnosis of HER-2 positive expression was calculated.Results Variance,90th and 99th percentiles were positively correlated with HER-2 expression(r=0.422,0.259 and 0.361,respectively,all P<0.05).The variance,90th and 99th percentiles of HER-2 positive group were significantly higher than those of HER-2 negative group(t=6.114,3.440and 5.073,respectivelly,all P<0.05).The optimal diagnostic threshold for variance to predict HER-2 positive expression was 711.19,while the sensitivity,specificity and area under receiver operating characteristic curve(AUC)were 68.2%,70.6%and 0.751,respectively.The optimal diagnostic threshold for the 90th percentile to predict HER-2 positive expression was 80.5,while the sensitivity,specificity and AUC were 56.1%,75.2%and 0.654,respectively.The optimal diagnostic threshold for the 99th percentile to predict HER-2 positive expression was 129,while the sensitivity,specificity and AUC were 57.6%,84.4%and 0.715,respectively.Conclusion Variance,90th and 99th percentiles have certain correlation with HER-2 expression,which can indirectly provide certain reference value for clinical treatment and prognosis evaluation of patients with breast invasive ductal carcinoma.