乳腺癌超声影像特征与分子分型相关性研究

Study on correlation between ultrasonographic characteristics and molecular subtypes of breast cancer

目的:研究乳腺癌超声影像特征与分子分型的关系以及在临床诊断中的应用价值。方法:选取泰安市中医医院2022年3月—2023年12月经病理证实的原发性乳腺癌患者164例进行回顾性分析,根据雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体-2(HER-2)、细胞增殖核抗原Ki-67的免疫组织化学检测结果进行分子分型,分为Luminal A型、Luminal B1(HER-2阴性)型、Luminal B2(HER-2阳性)型、ERBB2+型、Basal-like型5组,分析不同分子分型超声影像特征。结果:5组分子亚型超声影像在肿瘤的肿瘤最大径、形态、边界、微钙化、后方回声方面,差异有统计学意义(P<0.05)。Luminal A型多形态不规则、边界不清、后方回声无变化、较少出现淋巴结转移。Luminal B(HER-2阴性)型较多出现形态不规则、边界不清、后方回声衰减、微钙化。肿瘤形态不规则、边界不清伴有淋巴结转移对诊断Luminal B(HER-2阳性)型有提示作用。Basal-like型乳腺癌多>2 cm,形态规则,边界清楚,后方回声无改变。而肿瘤>2 cm、形态不规则、边界不清、微钙化、淋巴结转移对ERBB2+型乳腺癌有提示作用。各组肿瘤纵横比、血流分级、弹性评分对比,差异无统计学意义(P>0.05)。结论:超声影像学特征可为乳腺癌分子分型诊断提供有价值的信息。

Objective To study the relationship between Sonographic Features and molecular subtypes of breast cancer and its application value in clinical diagnosis.Methods 164 cases of primary breast cancer confirmed by pathology from March 2022 to December 2023 in Tai'an Traditional Chinese Medicine Hospital were selected for retrospective analysis.According to the expressing of estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(HER-2)and proliferating cell nuclear antigen(Ki-67).Molecular subtypes of breast cancer were categorized in Luminal A,Lumina B1(HER-2 negative),Luminal B2(HER-2 positive),ERBB2+and Basal-like five groups.Sonographic features of different molecular subtypes were analyzed.Results There were significant differences in the maximum diameter of tumor,morphology,boundary,micro-calcification and posterior echo of the five groups of molecular subtypes(P<0.05).Most Luminal A group had irregular shape,obscure boundary,no change of posterior echo and less lymph node metastasis.Luminal B1(HER-2 negative)group usually appeared irregular shape,obscure boundary,echo attenuation and micro-calcification.In ultrasound signs,irregular shape,obscure boundary and lymph node metastasis with the tumor had implications for the diagnosis of Luminal B2(HER-2 positive)subtype.Most Basal-like group appeared more than 2 cm,clear boundary,no change of posterior echo.While the tumor size more than 2 cm,with irregular shape,obscure boundary,micro-calcification and lymph node metastasis have implications for the diagnosis of ERBB2+subtype.There was no statistically significant difference in aspect ratio,blood flow grading,and elasticity score among the groups of tumors(P>0.05).Conclusion The analysis of ultrasound can provide valuable information for the diagnosis of molecular subtypes of breast cancer.