摘要
目的探讨常规超声及声辐射力脉冲成像(Acoustic Radiation Force Impulse,ARFI)技术在乳腺癌免疫组化分型中的应用价值。方法综回顾性分析148例经手术或穿刺病理证实的乳腺癌患者常规超声征象及ARFI技术剪切波速度值。根据免疫组化中ER、PR、HerbB-2、Ki-67的表达强度,将乳腺癌患者分为4种类型,即管腔上皮A型、管腔上皮B型、HerbB-2过表达型及三阴性型,比较四组不同免疫组化分型乳腺癌常规超声征象及剪切波速度值是否有差异。结果三阴型乳腺癌多表现为肿块>2.0 cm(65.00%)、形态规则(30.00%)、边界清晰(45.00%),并且三阴型乳腺癌淋巴结转移率较高(40.00%);管腔上皮A型中边缘毛刺(40.43%)、纵横比>1(65.96%)征象显著高于其他各型;HerbB-2过表达型乳腺癌常伴微钙化(42.86%)及血流分级Ⅱ-Ⅲ级(36.67%);四组不同免疫组化分型乳腺癌的剪切波速度值结果显示,管腔上皮A型组的剪切波速度值最低,而HerbB-2过表达型组剪切波速度值高于管腔上皮A型、管腔上皮B型及三阴型,差异有统计学意义。结论不同免疫组化分型乳腺癌常规超声征象及ARFI技术剪切波速度值有差异,常规超声结合ARFI技术可初步预估乳腺癌的生物学行为,为新辅助化疗疗效的评估及指导穿刺活检提供帮助。
Objective To discuss the application value of conventional ultrasound and acoustic radiation force impulse(ARFI)technology in immunohistochemical typing of breast cancer. Methods Conventional ultrasonic images and shear wave velocity values by ARFI technology of 148 breast cancer patients were retrospectively analyzed, which were confirmed by surgery or puncture pathology. According to the expression of the ER, PR, HerbB-2 and Ki-67 in immunohistochemical, breast cancer patients were divided into four types, namely luminal epithelium type A, luminal epithelium type B, HerbB-2 overexpression type and triple-negative type. Then differences of conventional ultrasonic images and shear wave velocity values in different immunohistochemical types of breast cancer were evaluated. Results The triple-negative breast cancer were mainly manifested as tumor >2.0 cm(65.00%), regular shape(30.00%), clear boundary(45.00%), and high lymph node metastasis rate(40.00%). The images of middle edge burr(40.43%) and aspect ratio >1(65.96%)of luminal epithelium type A were significantly higher than those of other types. HerbB-2 overexpression type of breast cancer often performanced with microcalcification(42.86%)and blood flow class Ⅱ-Ⅲ grade(36.67%). The results of the shear wave velocity values of the four groups of differentiated immunohistochemical breast cancer showed that the shear wave velocity values of the luminal epithelium type A group were the lowest, while the shear wave velocity values of the Herbb-2 overexpression group were higher than those of the luminal epithelium type A, luminal epithelium type B and triple-negative types, with statistically significant differences. Conclusion There are differences between conventional ultrasonographic images and shear wave velocity values of different immunohistochemical breast cancer types in different groups. Conventional ultrasonography combined with ARFI technology can preliminarily predict the biological behavior of breast cancer and provide help for the evaluation of neoa
作者
刘倩
红华
王芳
李敏
吴国柱
孙冉
LIU Qian;HONG Hua;WANG Fang;LI Min;WU Guozhu;SUN Ran(Department of Ultrasound, Inner Mongolia People’s Hospictal, Hohhot Inner Mongolia 010017, China)
出处
《中国医疗设备》
2019年第5期68-72,共5页
China Medical Devices
基金
内蒙古自治区自然科学基金项目(2012MS1194
2017MS0850)
关键词
常规超声
声辐射力脉冲成像
乳腺癌
免疫组化分型
conventional ultrasound
acoustic radiation force impulse
breast cancer
immunohistochemical typing
