乳腺癌患者免疫表型与超声征像变化的对应性分析
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摘要
目的探讨乳腺癌患者常见免疫表型与超声征象的对应关系。方法收集我院确诊的乳腺癌患者65例,所有患者均经病理检查确诊,并免疫组化二步法检测乳腺癌分子生物标记物包括ER、PR、HER2、Ki67等指标,同时患者术前均行超声检测,比较上述免疫标记物与超声征像包括毛刺征、内部微小钙化、后方回声、肿瘤边缘和内部血流等级的关系。结果:乳腺癌组织中ER、PR的阳性表达与超声征像中"毛刺征"相关(χ~2=6.221和7.114,P<0.05),ER、PR均与超声征像中的后方回声、内部微小钙化和内部血流无明显相关性(P>0.05);HER2阳性表达与超声征像中的"内部血流"和"内部微小钙化"相关(χ~2=8.224和4.562,P<0.05),Ki-67与超声征像中的"内部微小钙化"有关(χ~2=4.998,P<0.05),HER2、Ki-67均与超声征像中的后方回声无明显相关性(P>0.05)。结论乳腺癌的超声恶性征像在一定程度上可以反映组织中ER、PR、HER2、Ki-67的表达状态,对指导乳腺癌的治疗和评估预后均具有重要价值。
Objective To investigate the corresponding relationship between the common immunophenotype and ultrasonographic signs in breast cancer patients. Methods Collected 65 cases patients with breast cancer in our hospital. all patients were diagnosed by pathological examination and detected indicators of breast cancer molecular biomarkers including ER,PR,HER2,Ki67 by two-step immunohistochemical method. With preoperative ultrasonic testing at the same time,compared the relationship between the immune markers and ultrasonic character including spicule signs,internal tiny calcification,rear echo,the tumor edge and internal blood levels. Results ER and PR positive expression in breast cancer tissue had correlation with ultrasonographic features of"spicule signs"(χ~2=6.221 and 6.221,respectively,P<0.05),ER,PR had no obvious correlation with features of rear echo,the microcalcifications within the mass and internal blood flow(P>0.05);HER2 positive expression had correlation with the features of the"internal blood flow"and"internal tiny calcification"(χ~2=8.224 and 8.224,P<0.05),Ki-67 had correlation with features of the microcalcifications within the mass(χ~2=4.998,P<0.05),HER2 and Ki-67 had no obvious correlation with features of rear echo(P>0.05). Conclusion Malignancy ultrasono-graphic features reflect a certain extent with the expression status of ER,PR,HER2 and Ki-67 in the tissue,which is a great value in guiding the treatment and evaluating the prognosis of breast cancer.
Objective To investigate the corresponding relationship between the common immunophenotype and ultrasonographic signs in breast cancer patients. Methods Collected 65 cases patients with breast cancer in our hospital. all patients were diagnosed by pathological examination and detected indicators of breast cancer molecular biomarkers including ER,PR,HER2,Ki67 by two-step immunohistochemical method. With preoperative ultrasonic testing at the same time,compared the relationship between the immune markers and ultrasonic character including spicule signs,internal tiny calcification,rear echo,the tumor edge and internal blood levels. Results ER and PR positive expression in breast cancer tissue had correlation with ultrasonographic features of"spicule signs"(χ~2=6.221 and 6.221,respectively,P<0.05),ER,PR had no obvious correlation with features of rear echo,the microcalcifications within the mass and internal blood flow(P>0.05);HER2 positive expression had correlation with the features of the"internal blood flow"and"internal tiny calcification"(χ~2=8.224 and 8.224,P<0.05),Ki-67 had correlation with features of the microcalcifications within the mass(χ~2=4.998,P<0.05),HER2 and Ki-67 had no obvious correlation with features of rear echo(P>0.05). Conclusion Malignancy ultrasono-graphic features reflect a certain extent with the expression status of ER,PR,HER2 and Ki-67 in the tissue,which is a great value in guiding the treatment and evaluating the prognosis of breast cancer.
引文
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[7]王少春,陈东风,曹长军,等.乳腺癌患者超声钼靶X线表现及分子生物学指标临床观察[J].济宁医学院学报,2013,36(4):261-271.
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[9]李银珍,黄道中,张青萍,等.乳腺浸润性导管癌超声征象与雌激素受体表达的相关性初探[J].中华超声影像学杂志,2005,14(6):449-451.
[10]金占强,徐晓红,周红莲,等.多参数分析声像图特征鉴别乳腺良恶性肿瘤[J].中国医药指南,2011,9(26):9-11.
[2 Van Diest PJ,Van der Wall E,Baak JP.Prognostic vahm of pro-liferation in invasive breast cancer:a review[J].J Clin Pathol,2004,57:675-681.
[3]宋小川,谢小军.乳腺导管原位癌超声征象与免疫组化标记物相关性研究[J].中国肿瘤临床与康复,2013,20(10):1074-1077.
[4]Alexander MC,Yankaskas BC,Biesemier KW.Association of stel-late mammographic pattern with survival in small invasive breasttumors[J].Am J Roentgenol,2006,187:29-37.
[5]华平,古吉敏,李天永,等.乳腺癌组织中C-erb B-2与雌激素和孕激素受体的关系及意义[J].四川肿瘤防治,2006,19:115-116.
[6]Mc Cormick Matthews LH,Noble F,Tod J,et al.Systematic review and Meta-analysis of immunohistochemical prognosticbiomarkers in resected oesophageal adenocarcinoma[J].Br J Cancer,2015,113(1):107-118.
[7]王少春,陈东风,曹长军,等.乳腺癌患者超声钼靶X线表现及分子生物学指标临床观察[J].济宁医学院学报,2013,36(4):261-271.
[8]Berry DA,Cirrincione C,Henderson IC,et al.Estrogen-receptor status and outcomes of modern chemotherapy for patientswith node-positive breast cancer[J].JAMA,2006,295(14):1658-1667.
[9]李银珍,黄道中,张青萍,等.乳腺浸润性导管癌超声征象与雌激素受体表达的相关性初探[J].中华超声影像学杂志,2005,14(6):449-451.
[10]金占强,徐晓红,周红莲,等.多参数分析声像图特征鉴别乳腺良恶性肿瘤[J].中国医药指南,2011,9(26):9-11.