不同分子分型乳腺癌的超声造影特征分析
|
摘要
目的探讨不同分子分型乳腺癌的超声造影特征,提高超声造影对其的诊断价值。方法选取81例经病理证实的乳腺癌患者,根据免疫组化结果将其分为Luminal A型、Luminal B型、HER-2型、三阴性型,分析不同分子分型乳腺癌的超声造影特征。结果 9例Luminal A型和46例Luminal B型以增强后边界不清,周边呈放射状汇聚,增强范围扩大多见;16例HER-2型以灌注缺损出现最多;10例三阴性乳腺癌特征性超声造影表现为增强后边界清晰,形态规整。各分子分型乳腺癌超声造影表现中增强边界、周边呈放射状汇聚及增强范围比较差异均有统计学意义(均P<0.05)。结论超声造影的特征性表现可预测乳腺癌的分子分型,为乳腺癌的术前诊断、制定治疗方案及评估预后提供有价值的信息。
Objective To explore the features of contrast-enhanced ultrasound findings of breast cancer for different molecular types,and to improve the diagnostic value. Methods Data from 81 cases of breast cancer confirmed pathologically were enrolled in this study.According to the immunohistochemical results,cases of breast cancer were categorized in Luminal A,Luminal B,HER-2 and triple-negative group.Sonographic features of different molecular subtypes were observed and recorded.Results Signs of the boundary was unclear after enhancement,and the periphery converged radially,and the expanded enhancement scope were found more frequently in 9 cases of Luminal A and 46 cases of Luminal B. The perfusion defect appeared most frequently in 16 cases of HER-2.After enhancement,the boundary was clear and the shape was regular in10 cases of triple-negative. The contrast-enhanced boundary,peripheral radial convergence and enhancement range of each molecular type of breast cancer were significantly different(all P<0.05). Conclusion Contrast-enhanced ultrasound can predict the molecular typing of breast cancer and provide valuable information for the diagnosis,treatment and prognosis of breast cancer before surgery.
Objective To explore the features of contrast-enhanced ultrasound findings of breast cancer for different molecular types,and to improve the diagnostic value. Methods Data from 81 cases of breast cancer confirmed pathologically were enrolled in this study.According to the immunohistochemical results,cases of breast cancer were categorized in Luminal A,Luminal B,HER-2 and triple-negative group.Sonographic features of different molecular subtypes were observed and recorded.Results Signs of the boundary was unclear after enhancement,and the periphery converged radially,and the expanded enhancement scope were found more frequently in 9 cases of Luminal A and 46 cases of Luminal B. The perfusion defect appeared most frequently in 16 cases of HER-2.After enhancement,the boundary was clear and the shape was regular in10 cases of triple-negative. The contrast-enhanced boundary,peripheral radial convergence and enhancement range of each molecular type of breast cancer were significantly different(all P<0.05). Conclusion Contrast-enhanced ultrasound can predict the molecular typing of breast cancer and provide valuable information for the diagnosis,treatment and prognosis of breast cancer before surgery.
引文
[1] van’t Veer LJ,Dai H,van de Vijver MJ,et al. Gene expression profiling predicts clinical outcome of breast cancer[J].Nature,2002,415(6871):530-536.
[2] Goldhirsch A,Wood WC,Coates AS,et al.Strategies for subtypes——dealing with the diversity of breast cancer:highlights of the St.Gallen International Expert Consensus on the primary therapy of early breast cancer 2011[J].Ann Oncol,2011,22(8):1736-1747.
[3]沈建红,林勇,沈始,等.应用ROC曲线分析超声造影对乳腺癌的诊断价值[J].广东医学,2009,30(3):396-397.
[4]林韵.乳腺癌超声造影定量分析参数值及增强模式与其分子分型的相关性初步研究[D].南宁:广西医科大学,2014.
[5]王小燕,康利克,蓝春勇,等.乳腺恶性肿块超声造影特征表现及诊断[J].中国超声医学杂志,2012,28(8):705-708.
[6] Leo JC,Lin VC.The activities of progesterone receptor isoform A and B are differentially modulated by their ligands in a gene-selective manner[J].Int J Cancer,2008,122(1):230-243.
[7]王雅婷,姚兰辉.乳腺癌超声表现与分子免疫组化指标关系研究新进展[J].临床超声医学杂志,2017,19(9):623-624.
[8] Suzuki N,Shiota T,Watanabe F,et al.Discovery of novel 5-alkynyl-4-anilinopyrimidines as potent,orally active dual inhibitors of EGFR and Her-2 tyrosine kinases[J].Bioorg Med Chem Lett,2012,22(1):456-460.
[9] Kim MY,Choi N.Mammographic and ultrasonographic features of triple-negative breast cancer:a comparison with other breast cancer subtypes[J].Acta Radiol,2013,54(8):889-894.
[10]胡一迪,谢粜侠,张辉,等.61例三阴性乳腺癌的临床病理特征及预后因素分析[J].中华内分泌外科杂志,2018,12(2):118-123.
[11] Eisenbrey JR,Dave JK,Merton DA,et al.Parametric imaging using subharnionic signals from ultrasound contrast agents in patients with breast lesions[J].Ultrasound Med,2011,30(1):85-92.
[12]何佳,冉海涛.超声造影在乳腺肿瘤诊断中的应用价值[J].临床超声医学杂志,2017,19(7):471-473.
[13]贾宛儒.基于不同分子分型的乳腺癌超声造影研究[D].上海:上海交通大学,2015.
[2] Goldhirsch A,Wood WC,Coates AS,et al.Strategies for subtypes——dealing with the diversity of breast cancer:highlights of the St.Gallen International Expert Consensus on the primary therapy of early breast cancer 2011[J].Ann Oncol,2011,22(8):1736-1747.
[3]沈建红,林勇,沈始,等.应用ROC曲线分析超声造影对乳腺癌的诊断价值[J].广东医学,2009,30(3):396-397.
[4]林韵.乳腺癌超声造影定量分析参数值及增强模式与其分子分型的相关性初步研究[D].南宁:广西医科大学,2014.
[5]王小燕,康利克,蓝春勇,等.乳腺恶性肿块超声造影特征表现及诊断[J].中国超声医学杂志,2012,28(8):705-708.
[6] Leo JC,Lin VC.The activities of progesterone receptor isoform A and B are differentially modulated by their ligands in a gene-selective manner[J].Int J Cancer,2008,122(1):230-243.
[7]王雅婷,姚兰辉.乳腺癌超声表现与分子免疫组化指标关系研究新进展[J].临床超声医学杂志,2017,19(9):623-624.
[8] Suzuki N,Shiota T,Watanabe F,et al.Discovery of novel 5-alkynyl-4-anilinopyrimidines as potent,orally active dual inhibitors of EGFR and Her-2 tyrosine kinases[J].Bioorg Med Chem Lett,2012,22(1):456-460.
[9] Kim MY,Choi N.Mammographic and ultrasonographic features of triple-negative breast cancer:a comparison with other breast cancer subtypes[J].Acta Radiol,2013,54(8):889-894.
[10]胡一迪,谢粜侠,张辉,等.61例三阴性乳腺癌的临床病理特征及预后因素分析[J].中华内分泌外科杂志,2018,12(2):118-123.
[11] Eisenbrey JR,Dave JK,Merton DA,et al.Parametric imaging using subharnionic signals from ultrasound contrast agents in patients with breast lesions[J].Ultrasound Med,2011,30(1):85-92.
[12]何佳,冉海涛.超声造影在乳腺肿瘤诊断中的应用价值[J].临床超声医学杂志,2017,19(7):471-473.
[13]贾宛儒.基于不同分子分型的乳腺癌超声造影研究[D].上海:上海交通大学,2015.