剪切波弹性成像评估乳腺浸润性导管癌病理分级的应用价值
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摘要
目的:探讨剪切波弹性成像(SWE)定量参数弹性模量值评估乳腺浸润性导管癌病理分级中的价值。方法:回顾性分析78例经病理证实的乳腺浸润性导管癌患者的SWE图像,按照病理组织学分级分为3组,其中Ⅰ级18例,Ⅱ级31例,Ⅲ级29例,分别测量各组病灶弹性模量值,对3组数据进行单因素方差分析(one-way ANOVA),并进行组间两两比较。采用Spearman相关分析检验弹性模量值与乳腺浸润性导管癌病理分级的相关性,进一步绘制ROC曲线确定诊断Ⅲ级乳腺浸润性导管癌的最佳临界点。结果:Ⅰ、Ⅱ、Ⅲ级乳腺浸润性导管癌的弹性模量值分别为(64. 34±8. 29),(80. 10±5. 90),(92. 47±7. 76) kPa,差异具有统计学意义(F=85. 12,P<0. 05),组间两两比较差异具有统计学意义(P<0. 05)。弹性模量值与乳腺浸润性导管癌病理分级表现为正相关(r=0. 75,P<0. 05),ROC曲线分析显示用于诊断Ⅲ级乳腺浸润性导管癌的弹性模量值的最佳临界点为86. 48 kPa,其诊断敏感度为89. 7%,特异度为91. 8%,准确度为91. 0%。结论:SWE定量参数弹性模量值在乳腺浸润性导管癌术前病理分级评估中具有较高的应用价值,它有助于预测病灶的恶性程度,并可为患者治疗计划的选择及预后评价提供更多信息。
Objective: To investigate the clinical application of shear wave elastography(SWE) in the evaluation of different pathological grades of breast invasive ductal carcinoma.Methods: A retrospective analysis of SWE in 78 patients with pathologically diagnosed breast invasive ductal carcinoma was per-formed. The patients were divided into three groups based on the grade of differentiation: group Ⅰ(18 cases), group Ⅱ(31 cases), and group Ⅲ(29 cases). The elastic modulus values were measured separately. The elastic modulus values of the three groups were analyzed by one-way ANOVA meth-od, and results were compared. Spearman correlative analysis test was used to evaluate the correlation between the elastic modulus values and pathological grade of breast invasive ductal carcinoma.The ROC curve was drawn, and the cutoff value for breast invasive ductal carcinoma of pathological grading Ⅲ was determined.Results: The elastic modulus values of group Ⅰ, group Ⅱ, and group Ⅲwere(64. 34±8. 29) kPa,(80. 10±5. 90) kPa, and(92. 47±7. 76) kPa, respectively with significant difference(F=85. 12, P<0. 05). And there was a positive correlation between elastic modulus val-ues and the pathological grades(r=0. 75, P<0. 05). ROC curve analysis showed that the elastic modulus value of the best critical point for diagnosis of pathological grading Ⅲ of breast invasive duc-tal carcinoma was 86. 48 kPa with sensitivity of 89. 7%, specificity of 91. 8% and accuracy of91. 0%.Conclusion: The elastic modulus value has high value in the evaluation of different pathological grades of breast ductal invasive carcinoma, which is helpful in predicting the malignancy of the le-sions and providing more information for treatment and prognostic evaluation.
Objective: To investigate the clinical application of shear wave elastography(SWE) in the evaluation of different pathological grades of breast invasive ductal carcinoma.Methods: A retrospective analysis of SWE in 78 patients with pathologically diagnosed breast invasive ductal carcinoma was per-formed. The patients were divided into three groups based on the grade of differentiation: group Ⅰ(18 cases), group Ⅱ(31 cases), and group Ⅲ(29 cases). The elastic modulus values were measured separately. The elastic modulus values of the three groups were analyzed by one-way ANOVA meth-od, and results were compared. Spearman correlative analysis test was used to evaluate the correlation between the elastic modulus values and pathological grade of breast invasive ductal carcinoma.The ROC curve was drawn, and the cutoff value for breast invasive ductal carcinoma of pathological grading Ⅲ was determined.Results: The elastic modulus values of group Ⅰ, group Ⅱ, and group Ⅲwere(64. 34±8. 29) kPa,(80. 10±5. 90) kPa, and(92. 47±7. 76) kPa, respectively with significant difference(F=85. 12, P<0. 05). And there was a positive correlation between elastic modulus val-ues and the pathological grades(r=0. 75, P<0. 05). ROC curve analysis showed that the elastic modulus value of the best critical point for diagnosis of pathological grading Ⅲ of breast invasive duc-tal carcinoma was 86. 48 kPa with sensitivity of 89. 7%, specificity of 91. 8% and accuracy of91. 0%.Conclusion: The elastic modulus value has high value in the evaluation of different pathological grades of breast ductal invasive carcinoma, which is helpful in predicting the malignancy of the le-sions and providing more information for treatment and prognostic evaluation.
引文
[1]李朝喜,温德惠,刘伟亮,等.彩色多普勒超声对乳腺癌新辅助化疗效果评价研究[J].海南医学院学报,2016,22(9):921-923.Li CX, Wen DH, Liu WL, et al. Value of color Dop-pler ultrasound in evaluating efficacy of neoadjuvant che-motherapy for breast cance[J]. Journal of Hainan Medi-cal University,2016,22(9):921-923.
[2]张卫,苏丹柯,罗宁斌,等. MR扩散加权成像表观扩散系数与乳腺浸润性导管癌病理分级相关性研究[J].磁共振成像,2015,6(2):131-135.Zhang W, Su DK, Luo NB, et al. Correlation between diffusion coefficient of MR diffusion-weighted imaging and pathological grading of invasive ductal carcinoma of breast[J]. Magnetic Resonance Imaging,2015,6(2):131-135.
[3]姚萌,陈圆圆,李智贤,等.实时剪切波弹性成像技术定量评价正常乳腺组织[J].中国超声医学杂志,2014,272(1):63-72.Yao M, Chen YY, Li ZX, et al. Quantitative evalua-tion of normal breast tissue by real-time shear wave elas-tography[J], Chinese Journal of Ultrasound Medicine,2014,272(1):63-72.
[4] Berg WA, Mendelson EB, Cosgrove DO, et al. Quan-titative maximum shear-wave stiffness of breast masses as a predictor of histopathologic severity[J]. Am J Roentgenol,2015,205(2):448-455.
[5]范向阳,李紫瑶,申凯凯,等.剪切波弹性成像联合超微血管显像在乳腺肿块良恶性鉴别诊断中的应用[J].中华超声影像学杂志,2016,25(9):795-799.Fan XY, Li ZY, Shen KK, et al. Application of shear wave elastography combined with ultravascular imaging in the differential diagnosis of benign and malignant breast masses[J]. Chinese Journal of Ultrasound Imag-ing, 2016,25(9):795-799.
[6]黄炎,李俊来,王知力,等.实时剪切波弹性成像定量评价乳腺良恶性病变[J].中国医学影像技术,2011,27(3):561-564.Huang Y, Li JL, Wang ZL, et al. Quantitative evalua-tion of benign and malignant breast lesions by real-time shear wave elastography[J]. China Medical Imaging Technology, 2011,27(3):561-564.
[7] Correas J, Tissier AM, Khairoune A, et al. Ultra-sound elastography of the prostate:state of the art[J].Diagn Interv Imaging, 2013,94(5):551-560.
[8] Evans A, Whelehan P, Thomson K, et al. Invasive breast cancer relationship between shear-wave elasto-graphic findings and histologic prognostic factors[J].Radiology, 2012,263(3):673-677.
[9]赵鹤楠,李紫瑶,俞卫东,等.剪切波弹性成像及超微血管成像在乳腺浸润性导管癌病理分级中的应用研究[J].中华超声影像学杂志,2017,26(2):146-150.Zhao HN, Li ZY, Yu WD, et al. Application of shear wave elastography and ultravascular imaging in the path-ological grading of invasive ductal carcinoma of breast[J]. Chin J Ultrasound Imaging, 2017,26(2):146-150.
[10] Arda K, Ciledag N, Aktas E, et al. Quantitative assessment of normal soft-tissue elasticity using shear-wave elastography[J]. AJR, 2011,197(3):532-536.
[11]?ebi Olgun D, Korkmazer B, K?l??F, et al. Use of shear wave elastography to differentiate benign and ma-lignant breast lesions[J]. Diagn Interv Radiol, 2014,20(3):239-244.
[12] Wang ZL, Li JL, Li M, et al. Study of quantitative elastography with supersonic shear imaging in the diag-nosis of breast tumours[J]. Radiol Med, 2013, 118(4):583-590.
[2]张卫,苏丹柯,罗宁斌,等. MR扩散加权成像表观扩散系数与乳腺浸润性导管癌病理分级相关性研究[J].磁共振成像,2015,6(2):131-135.Zhang W, Su DK, Luo NB, et al. Correlation between diffusion coefficient of MR diffusion-weighted imaging and pathological grading of invasive ductal carcinoma of breast[J]. Magnetic Resonance Imaging,2015,6(2):131-135.
[3]姚萌,陈圆圆,李智贤,等.实时剪切波弹性成像技术定量评价正常乳腺组织[J].中国超声医学杂志,2014,272(1):63-72.Yao M, Chen YY, Li ZX, et al. Quantitative evalua-tion of normal breast tissue by real-time shear wave elas-tography[J], Chinese Journal of Ultrasound Medicine,2014,272(1):63-72.
[4] Berg WA, Mendelson EB, Cosgrove DO, et al. Quan-titative maximum shear-wave stiffness of breast masses as a predictor of histopathologic severity[J]. Am J Roentgenol,2015,205(2):448-455.
[5]范向阳,李紫瑶,申凯凯,等.剪切波弹性成像联合超微血管显像在乳腺肿块良恶性鉴别诊断中的应用[J].中华超声影像学杂志,2016,25(9):795-799.Fan XY, Li ZY, Shen KK, et al. Application of shear wave elastography combined with ultravascular imaging in the differential diagnosis of benign and malignant breast masses[J]. Chinese Journal of Ultrasound Imag-ing, 2016,25(9):795-799.
[6]黄炎,李俊来,王知力,等.实时剪切波弹性成像定量评价乳腺良恶性病变[J].中国医学影像技术,2011,27(3):561-564.Huang Y, Li JL, Wang ZL, et al. Quantitative evalua-tion of benign and malignant breast lesions by real-time shear wave elastography[J]. China Medical Imaging Technology, 2011,27(3):561-564.
[7] Correas J, Tissier AM, Khairoune A, et al. Ultra-sound elastography of the prostate:state of the art[J].Diagn Interv Imaging, 2013,94(5):551-560.
[8] Evans A, Whelehan P, Thomson K, et al. Invasive breast cancer relationship between shear-wave elasto-graphic findings and histologic prognostic factors[J].Radiology, 2012,263(3):673-677.
[9]赵鹤楠,李紫瑶,俞卫东,等.剪切波弹性成像及超微血管成像在乳腺浸润性导管癌病理分级中的应用研究[J].中华超声影像学杂志,2017,26(2):146-150.Zhao HN, Li ZY, Yu WD, et al. Application of shear wave elastography and ultravascular imaging in the path-ological grading of invasive ductal carcinoma of breast[J]. Chin J Ultrasound Imaging, 2017,26(2):146-150.
[10] Arda K, Ciledag N, Aktas E, et al. Quantitative assessment of normal soft-tissue elasticity using shear-wave elastography[J]. AJR, 2011,197(3):532-536.
[11]?ebi Olgun D, Korkmazer B, K?l??F, et al. Use of shear wave elastography to differentiate benign and ma-lignant breast lesions[J]. Diagn Interv Radiol, 2014,20(3):239-244.
[12] Wang ZL, Li JL, Li M, et al. Study of quantitative elastography with supersonic shear imaging in the diag-nosis of breast tumours[J]. Radiol Med, 2013, 118(4):583-590.