老年乳腺癌超声影像特征与分子分型的相关性研究

Correlation between ultrasonic imaging features and molecular subtypes of elderly breast cancer

目的 分析老年乳腺癌不同分子分型的超声影像特征。方法 回顾性分析行乳腺超声检查并经手术病理证实的117例老年乳腺癌病人的临床资料,根据免疫组化结果,确定肿瘤分子分型。观察并比较不同分子分型老年乳腺癌的病理特点、组织学分级和超声影像特征。结果 117例病人中,Luminal A型70例,Luminal B型14例,HER-2阳性12例,三阴型21例,不同分子分型病人的病理类型均以浸润性导管癌人数最多。不同分子分型浸润性导管癌病人的组织学分级比较,差异有统计学意义(χ^(2)=19.700,P<0.001)。根据老年乳腺癌的超声检查结果,肿瘤的形态、边缘、内部钙化、后方特征及腋窝异常淋巴结情况在不同分子分型间差异均有统计学意义(P<0.05);肿瘤的最大径线、纵横比、内部回声及血流情况在不同分子分型间差异无统计学意义(P>0.05)。结论 老年乳腺癌的分子分型与超声影像表现存在一定的相关性,通过观察其影像结果可以辅助临床医生判断老年乳腺癌的分子分型。

Objective To analyze the ultrasonic imaging features of different molecular subtypes of breast cancer in the elderly.Methods The clincal data of 117 elderly patients with breast cancer confirmed by pathology who underwent breast ultrasonic examination were retrospectively analyzed.The molecular typing of the patients were determined by the result of immunocytochemistry.The pathological characteristics,histological grading and ultrasonic imaging features of elderly breast cancer with different molecular subtypes were observed and compared.Results Among 117 patients,70 cases presented with Luminal A type,14 cases presenting with Luminal B type,12 cases presenting with human epidermal growth factor receptor 2(HER-2) positive type and 21 cases presenting with triple-negative type.Invasive ductal carcinoma was the main pathological type among the patients with different molecular subtypes.The difference of histological grading among invasive ductal carcinoma patients with different molecular subtypes was statistically significant(χ^(2)=19.700,P<0.001).According to the result of ultrasonic examination in the elderly patients with breast cancer,there were significant differences in the tumor morphology,tumor margin,internal calcification,posterior echo and axillary lymph node among the patients with different molecular subtypes(P<0.05);While there were no significant differences in tumor size,aspect ratio,internal echo and blood flow(P>0.05).Conclusions There is a certain correlation between the ultrasonic imaging features and molecular subtypes in the elderly patients with breast cancer.The ultrasonic imaging can be helpful to determine the molecular typing of elderly breast cancer.