自动乳腺全容积成像与乳腺癌分子亚型的相关性研究
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摘要
目的探讨超声自动乳腺全容积成像(automated breast volume scanner,ABVS)与乳腺癌分子亚型的相关性。方法回顾性分析2016年1月～2018年1月于笔者医院诊治的270例乳腺癌患者术前ABVS检查报告及术后病理结果。依据免疫组化结果中ER,PR,Her-2的表达情况及Ki-67水平将患者分为luminal-A组(122例)、luminal-B组(83例)、Her-2组(39例)及三阴性组(26例)。对照分析4组患者的病理特征与ABVS影像特征(汇聚征、高回声晕、微钙化、后方回声特征、形态等),应用多因素Logistic回归模型分析ABVS影像特征与乳腺癌分子亚型的相关性。结果 4组患者病理类型、组织学分级、肿瘤直径比较,差异无统计学意义(P>0.05);Her-2组和三阴性组组织学Ⅲ级的比例高于luminal-A组和luminal-B组(P<0.05);4组患者的汇聚征、高回声晕、微钙化、后方回声特征及形态比较,差异有统计学意义(P<0.05),汇聚征、高回声晕、后方回声衰减在luminal-A组出现率高,无汇聚征、微钙化和形态规则分别在luminal-B组、Her-2组和三阴性组出现率较高,内部回声和边缘比较,差异无统计学意义(P>0.05);多因素Logistic回归模型显示汇聚征和高回声晕是luminal-A型的独立相关因素;无汇聚征、微钙化和形态规则分别是luminal-B型、Her-2型和三阴性型的独立相关因素。结论 ABVS影像学特征,与乳腺癌各分子亚型有一定的相关性,可协助制定乳腺癌患者的治疗方案及判断预后。
Objective To explore the correlation between automated breast volume scanner(ABVS) and molecular subtypes of breast cancer. Methods Retrospective analysis the preoperative ABVS imaging examination and the postoperative pathological diagnosis of 270 cases of breast cancer treated in author′s hospital from January 2016 to January 2018 was performed. According to the expression of ER, PR, Her-2 and Ki-67 level, the patients were divided into luminal-A group(122 cases), luminal-B group(83 cases), Her-2 group(39 cases) and triple negative group(26 cases). The pathological features and ABVS imaging features(retraction phenomenon, echogenic halo, microcalcification, post-acoustic features, shape and so on) of the four groups were compared. Multivariate Logistic regression model was used to analyze the correlation between ABVS image characteristics and molecular subtypes of breast cancer. ResultsThere was no statistical difference in the pathological type, histological grade and tumor diameter between the four groups(P>0.05), and the proportion of histological grade Ⅲ in Her-2 group and the triple negative group was significantly higher than that in the luminal-A group and the luminal-B group(P<0.05). Among the ABVS imaging features of the four groups, there was a statistical difference in retraction phenomenon, echogenic halo, microcalcification, post-acoustic features and shape(P<0.05). Retraction phenomenon, echogenic halo and post-acoustic shadowing occurred more frequently in the luminal-A group(P<0.05). Absense of retraction phenomenon, microcalcification and regular shape were more likely to be seen in the luminal-B, Her-2 and triple negative group,respectively(P<0.05), and there was no statistical difference in echogenicity and margins(P>0.05). Logistic analysis showed that the independent related factors of luminal-A subtype were retraction phenomenon and echogenic halo, absense of retraction phenomenon, microcalcification and regular shape were the independent related factors of luminal-B, Her-2 and triple negative subtype, respectively. ConclusionThere is a certain correlation between image features of automated breast volume scanner and molecular subtypes of breast cancer, preoperative ABVS examination can be used to judge the prognosis of breast cancer patients and to formulate a preliminary treatment plan.
Objective To explore the correlation between automated breast volume scanner(ABVS) and molecular subtypes of breast cancer. Methods Retrospective analysis the preoperative ABVS imaging examination and the postoperative pathological diagnosis of 270 cases of breast cancer treated in author′s hospital from January 2016 to January 2018 was performed. According to the expression of ER, PR, Her-2 and Ki-67 level, the patients were divided into luminal-A group(122 cases), luminal-B group(83 cases), Her-2 group(39 cases) and triple negative group(26 cases). The pathological features and ABVS imaging features(retraction phenomenon, echogenic halo, microcalcification, post-acoustic features, shape and so on) of the four groups were compared. Multivariate Logistic regression model was used to analyze the correlation between ABVS image characteristics and molecular subtypes of breast cancer. ResultsThere was no statistical difference in the pathological type, histological grade and tumor diameter between the four groups(P>0.05), and the proportion of histological grade Ⅲ in Her-2 group and the triple negative group was significantly higher than that in the luminal-A group and the luminal-B group(P<0.05). Among the ABVS imaging features of the four groups, there was a statistical difference in retraction phenomenon, echogenic halo, microcalcification, post-acoustic features and shape(P<0.05). Retraction phenomenon, echogenic halo and post-acoustic shadowing occurred more frequently in the luminal-A group(P<0.05). Absense of retraction phenomenon, microcalcification and regular shape were more likely to be seen in the luminal-B, Her-2 and triple negative group,respectively(P<0.05), and there was no statistical difference in echogenicity and margins(P>0.05). Logistic analysis showed that the independent related factors of luminal-A subtype were retraction phenomenon and echogenic halo, absense of retraction phenomenon, microcalcification and regular shape were the independent related factors of luminal-B, Her-2 and triple negative subtype, respectively. ConclusionThere is a certain correlation between image features of automated breast volume scanner and molecular subtypes of breast cancer, preoperative ABVS examination can be used to judge the prognosis of breast cancer patients and to formulate a preliminary treatment plan.
引文
1 郝博闻,张喜平.晚期乳腺癌综合治疗影响因素研究进展[J].内蒙古医学杂志,2017,49(2):171-172
2 Girometti R,Zanotel M,Londero V,et al.Automated breast volume scanner (ABVS) in assessing breast cancer size:a comparison with conventional ultrasound and magnetic resonance imaging[J].Eur Radiol,2018,28(3):1000-1008
3 中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2015版)[J].中国癌症杂志,2015,25 (9):692-754
4 黄振兰,叶晓颖,邹洁莲,等.自动乳腺全容积成像技术(ABVS)对比常规超声对乳腺肿块鉴别诊断的价值分析[J].齐齐哈尔医学院学报,2016,37(21):2683-2684
5 Choi EJ,Choi H,Park EH,et al.Evaluation of an automated breast volume scanner according to the fifth edition of BI-RADS for breast ultrasound compared with hand-held ultrasound[J].Eur J Radiol,2018,99(12):138-145
6 中华人民共和国国家卫生和计划生育委员会.原发性乳腺癌规范化诊疗指南(试行)[J].中国医学前沿杂志:电子版,2013,5 (5):30-37
7 骆圣娟,刘艳,赵穗琼.自动乳腺全容积成像技术对乳腺导管原位癌定位诊断的临床价值[J].深圳中西医结合杂志,2017,27(16):60-61
8 矫健,孙欣,徐晓慧,等.超声自动乳腺全容积成像与钼靶联合诊断乳腺肿瘤的价值[J].现代肿瘤医学,2015,23(6):798-802
9 Wu J,Wang Y,Yu J,et al.Identification of implanted mesh after incisional hernia repair using an automated breast volume scanner[J].J Ultrasound Med,2015,34(6):1071-1081
10 包凌云,谭艳娟,朱罗茜,等.自动乳腺全容积成像在乳腺导管原位癌诊断中的应用价值[J].中华医学超声杂志:电子版,2015,11(1):53-56
11 Schmachtenberg C,Fischer T,Hamm B,et al.Diagnostic performance of automated breast volume scanning (ABVS) compared to handheld ultrasonography with breast MRI as the gold standard[J].Acad Radiol,2017,24(8):954-961
12 张超,骆瑞珍,李静艳,等.自动乳腺全容积成像在乳腺癌诊断中的应用[J].实用临床医药杂志,2016,20(23):68-71
13 Zheng FY,Lu Q,Huang BJ,et al.Imaging features of automated breast volume scanner:correlation with molecular subtypes of breast cancer[J].Eur J Radiol,2017,8(6):267-275
14 何其佳,赵玉珍.自动乳腺全容积成像技术诊断乳腺病灶的研究进展[J].中国医疗设备,2015,30(12):79-82
15 谭艳娟,包凌云,黄安茜,等.乳腺恶性肿瘤冠状面汇聚征与临床病理学相关因素分析[J].中国超声医学杂志,2015,31(7):587-589
16 Zheng FY,Yan LX,Huang BJ,et al.Comparison of retraction phenomenon and BI-RADS-US descriptors in differentiating benign and malignant breast masses using an automated breast volume scanner[J].Eur J Radiol,2015,84(11):2123-2129
17 王炜,包凌云,谭艳娟,等.冠状面引导下乳腺非肿块性病变穿刺活检的应用价值[J].中国超声医学杂志,2017,17(1):15-18
18 陈森,陈铃,张建兴,等.自动乳腺全容积成像的冠状面特征对改良BI-RADS分类的临床研究[J].实用医学杂志,2017,33(5):797-800
19 Xu C,Wei S,Xie Y,et al.Three-dimensional assessment of automated breast volume scanner compared with handheld ultrasound in pre-operative breast invasive ductal carcinomas:a pilot study of 51 cases[J].Ultrasound Med Biol,2016,42(9):2089-2096
20 Van LE,Lagendijk M,Heijkoop E,et al.Three-dimensional ultrasonography of the breast;an adequate replacement for MRI in neoadjuvant chemotherapy tumour response evaluation?-RESPONDER trial[J].Eur J Radiol,2018,104(12):94-100
2 Girometti R,Zanotel M,Londero V,et al.Automated breast volume scanner (ABVS) in assessing breast cancer size:a comparison with conventional ultrasound and magnetic resonance imaging[J].Eur Radiol,2018,28(3):1000-1008
3 中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2015版)[J].中国癌症杂志,2015,25 (9):692-754
4 黄振兰,叶晓颖,邹洁莲,等.自动乳腺全容积成像技术(ABVS)对比常规超声对乳腺肿块鉴别诊断的价值分析[J].齐齐哈尔医学院学报,2016,37(21):2683-2684
5 Choi EJ,Choi H,Park EH,et al.Evaluation of an automated breast volume scanner according to the fifth edition of BI-RADS for breast ultrasound compared with hand-held ultrasound[J].Eur J Radiol,2018,99(12):138-145
6 中华人民共和国国家卫生和计划生育委员会.原发性乳腺癌规范化诊疗指南(试行)[J].中国医学前沿杂志:电子版,2013,5 (5):30-37
7 骆圣娟,刘艳,赵穗琼.自动乳腺全容积成像技术对乳腺导管原位癌定位诊断的临床价值[J].深圳中西医结合杂志,2017,27(16):60-61
8 矫健,孙欣,徐晓慧,等.超声自动乳腺全容积成像与钼靶联合诊断乳腺肿瘤的价值[J].现代肿瘤医学,2015,23(6):798-802
9 Wu J,Wang Y,Yu J,et al.Identification of implanted mesh after incisional hernia repair using an automated breast volume scanner[J].J Ultrasound Med,2015,34(6):1071-1081
10 包凌云,谭艳娟,朱罗茜,等.自动乳腺全容积成像在乳腺导管原位癌诊断中的应用价值[J].中华医学超声杂志:电子版,2015,11(1):53-56
11 Schmachtenberg C,Fischer T,Hamm B,et al.Diagnostic performance of automated breast volume scanning (ABVS) compared to handheld ultrasonography with breast MRI as the gold standard[J].Acad Radiol,2017,24(8):954-961
12 张超,骆瑞珍,李静艳,等.自动乳腺全容积成像在乳腺癌诊断中的应用[J].实用临床医药杂志,2016,20(23):68-71
13 Zheng FY,Lu Q,Huang BJ,et al.Imaging features of automated breast volume scanner:correlation with molecular subtypes of breast cancer[J].Eur J Radiol,2017,8(6):267-275
14 何其佳,赵玉珍.自动乳腺全容积成像技术诊断乳腺病灶的研究进展[J].中国医疗设备,2015,30(12):79-82
15 谭艳娟,包凌云,黄安茜,等.乳腺恶性肿瘤冠状面汇聚征与临床病理学相关因素分析[J].中国超声医学杂志,2015,31(7):587-589
16 Zheng FY,Yan LX,Huang BJ,et al.Comparison of retraction phenomenon and BI-RADS-US descriptors in differentiating benign and malignant breast masses using an automated breast volume scanner[J].Eur J Radiol,2015,84(11):2123-2129
17 王炜,包凌云,谭艳娟,等.冠状面引导下乳腺非肿块性病变穿刺活检的应用价值[J].中国超声医学杂志,2017,17(1):15-18
18 陈森,陈铃,张建兴,等.自动乳腺全容积成像的冠状面特征对改良BI-RADS分类的临床研究[J].实用医学杂志,2017,33(5):797-800
19 Xu C,Wei S,Xie Y,et al.Three-dimensional assessment of automated breast volume scanner compared with handheld ultrasound in pre-operative breast invasive ductal carcinomas:a pilot study of 51 cases[J].Ultrasound Med Biol,2016,42(9):2089-2096
20 Van LE,Lagendijk M,Heijkoop E,et al.Three-dimensional ultrasonography of the breast;an adequate replacement for MRI in neoadjuvant chemotherapy tumour response evaluation?-RESPONDER trial[J].Eur J Radiol,2018,104(12):94-100