老年乳腺浸润性导管癌超声特征及其与分子分型相关性研究

Ultrasound features of invasive ductal carcinoma of the breast in the elderly and its correlation with molecular typing

目的探讨老年乳腺浸润性导管癌的超声特征及其与分子分型的相关性。方法回顾性分析2020年7月至2022年7月老年乳腺浸润性导管癌127例作为研究对象。所有研究对象均于术前2周内行乳腺超声检查,均由我院两名高年资深超声科医生分析超声声像图,包括病灶直径、形态、边界、毛刺、分叶、后方回声、血流情况。分子分型包括luminal A型、luminal B型、HER-2过表达型和基底样型。采用统计学软件SPSS 23.0处理,计数资料采用卡方检验,以[例(%)]表示,以P<0.05有统计学意义。结果老年超声特征中,病灶直径≤2 cm居多,形态以不规则形为主,边界以模糊为主,毛刺和分叶居多,后方回声以衰减为主,血流以不丰富为主。分子分型中,luminal A型13例,luminal B型72例,HER-2过表达型27例,基底样型15例。乳腺浸润性导管癌分子分型的相关因素包括病灶直径、形态、边界、毛刺和后方回声(P<0.05),但与分叶和血流情况无明显相关性(P>0.05)。结论老年乳腺浸润性导管癌的超声特征以形态不规则、边界模糊、毛刺、分叶和后方回声衰减为主,且分子分型与病灶直径、形态、边界、毛刺和后方回声具有明显相关性。

Objective To investigate the ultrasonographic characteristics of senile invasive ductal carcinoma of breast and its correlation with molecular typing.Methods 127 elderly patients with invasive ductal carcinoma of breast from July 2020 to July 2022 were retrospectively analyzed.All subjects underwent breast ultrasound examination within 2 weeks before surgery.Ultrasound images were analyzed by 2 senior sonographers in our hospital,including lesion diameter,shape,boundary,burr,lobule,posterior echo,and blood flow.Molecular types include luminal A,luminal B,HER-2 overexpression and basal-like.Statistical software SPSS 23.0 was used for processing,and counting data were expressed as percentage/case number byχ2 test.P<0.05 was statistically significant.Results In the ultrasonic characteristics of elderly patients,most lesions were less than 2cm in diameter,irregular in shape,blurred in boundary,burr and lobed,attenuated in rear echo and not rich in blood flow.Molecular typing included luminal A type in 13 cases,luminal B type in 72 cases,HER-2 overexpression type in 27 cases and basal-like type in 15 cases.The factors related to molecular classification of invasive ductal carcinoma of breast included lesion diameter,morphology,boundary,burr and posterior echo(P<0.05),but there was no significant correlation with lobular and blood flow(P>0.05).Conclusion The ultrasonic characteristics of senile invasive ductal carcinoma of breast were mainly irregular shape,blurred boundary,burr,lobule and attenuation of posterior echo,and the molecular classification was significantly correlated with the focus diameter,shape,boundary,burr and posterior echo.