超声成像技术预测乳腺癌分子分型的研究进展

Research progress of ultrasound imaging technology in predicting molecular subtypes of breast cancer

乳腺癌是困扰全球女性的恶性肿瘤之一,早期诊断、精准治疗是专家学者的共同目标。乳腺癌肿瘤异质性很强,不同分子分型的生物学行为、影像学、病理特征及预后转归差异较大,术前明确分子分型对临床选择治疗方案有重要指导意义。目前对乳腺癌进行分子分型主要依靠穿刺活检,但有创检查患者接受度较低且局部组织无法反映整体病灶。近年来如何通过影像技术无创预测受到国内外学者的关注,超声作为目前应用最广泛的乳腺癌术前评估辅助检查技术,有简便、无创、实时、可重复等优点。常规超声、弹性成像、超声造影(CEUS)、三维超声(3D-US)、影像组学、人工智能(AI)乳腺超声等超声技术及多模态超声技术的联合使用在无创评估乳腺癌分子分型方面显示出了巨大的潜力。该文就超声成像技术预测乳腺癌分子分型的研究进展、可行性与局限性进行综述。

Breast cancer is one of the malignant tumors that afflicts women worldwide.Early diagnosis and precise treatment are the common goals of scholars.Breast cancer is a tumor with strong heterogeneity,and the biological behavior,imaging,pathological features and prognosis of different molecular subtypes are significantly different.Therefore,it is of great guiding significance to define molecular subtypes before operation for clinical treatment options.At present,the molecular subtypes of breast cancer mainly rely on puncture biopsy.However,the acceptance of invasive examination is low,and the local tissue cannot reflect the overall lesion.In recent years,how to noninvasively predict molecular subtypes by imaging technology has attracted the attention of scholars at home and abroad.As the most widely used auxiliary examination technique for preoperative evaluation of breast cancer,ultrasound is simple,noninvasive,real-time and repeatable.Ultrasound technologies such as conventional ultrasound,elastography,contrast-enhanced ultrasound(CEUS),three-dimensional ultrasound(3D-US),radiomics,and artificial intelligence(AI)breast ultrasound have shown great potential in predicting molecular subtypes of breast cancer.This article reviews the progress,the feasibility and limitations of ultrasound imaging technology in predicting molecular subtypes of breast cancer.