摘要
目的通过分析早期肿块型乳腺浸润性导管癌的超声征象与分子分型的相关性,探讨超声征象对早期肿块型乳腺浸润性导管癌分子分型的诊断价值。方法纳入298例术前诊断为Ⅰ~Ⅱ期乳腺癌,且乳腺超声检查显示为肿块型病变,并经手术病理证实为乳腺浸润性导管癌的患者。比较此类乳腺癌不同分子分型的超声征象差异,Logistic回归分析Luminal型、HER-2过表达型和三阴型的影响因素。结果298例中有Luminal A型26例、Luminal B型178例、HER-2过表达型54例、三阴型40例。不同分子分型的乳腺癌患者在发病年龄、直径、边缘、形态、内部钙化、后方回声等方面的差异有统计学意义(P<0.05);腋下淋巴结转移、生长方向、回声、血流信号间的差异无统计学意义(P>0.05)。形态不规则(OR=1.206,95%CI:1.039~1.400,P<0.05)、边缘不光整(OR=1.490,95%CI:1.224~1.814,P<0.05)是Luminal型的独立危险因素;后方回声增强(OR=0.674,95%CI:0.603~0.752,P<0.05)是其独立保护因素。边缘不光整(OR=0.688,95%CI:0.564~0.838,P<0.05)是HER-2过表达型的独立保护因素。形态不规则(OR=0.820,95%CI:0.728~0.923,P<0.05)、后方回声衰减(OR=0.714,95%CI:0.644~0.792,P<0.05)、后方回声无改变(OR=0.723,95%CI:0.662~0.791,P<0.05)、后方混合回声(OR=0.790,95%CI:0.638~0.978,P<0.05)是三阴型的独立保护因素。结论超声征象能为早期肿块型乳腺浸润性导管癌的分子分型诊断提供影像学依据,具有一定的临床意义。
Objective To investigate the diagnostic value of ultrasonic signs to molecular typing of early mass-type breast invasive ductal carcinoma by analyzing the correlation between ultrasonographic features and molecular types of early mass-type breast invasive ductal carcinoma.Methods A total of 298 patients with stageⅠ-Ⅱbreast cancer who were diagnosed by ultrasonography as mass-type lesions before operation and were confirmed as breast invasive ductal carcinoma by surgical pathology were retrospective included.The differences of ultrasonographic features and molecular subtypes were compared and analyzed.The influencing factors of Luminal type,HER-2 overexpression type and triple-negative type were analyzed by Logistic regression.Results Among 298 patients,26 cases were Luminal A type,178 cases were Luminal B type,54 cases were HER-2 overexpression type and 40 cases were triple negative type.There were significant differences in age of onset,tumor diameter,margin,morphology,internal calcification and posterior echo between patients with different molecular types(P<0.05).There were no significant differences in axillary lymph node metastasis,growth direction,echo and blood flow signal(P>0.05).Irregular shape(OR=1.206,95%CI:1.039-1.400,P<0.05)and rough edge(OR=1.490,95%CI:1.224-1.814,P<0.05)were independent risk factors for Luminal type.The enhancement in posterior echo was the independent protective factor for Luminal type(OR=0.674,95%CI:0.603-0.752,P<0.05).Rough edge was the independent protective factor for HER-2 overexpression type(OR=0.688,95%CI:0.564-0.838,P<0.05).Irregular shape(OR=0.820,95%CI:0.728-0.923,P<0.05),attenuation in posterior echo(OR=0.714,95%CI:0.644-0.792,P<0.05),no change in posterior echo(OR=0.723,95%CI:0.662-0.791,P<0.05)and mixed echo in posterior echo(OR=0.790,95%CI:0.638-0.978,P<0.05)were independent protective factors for triple-negative type.Conclusion The ultrasonographic features can provide a basis for molecular typing of early mass-type breast invasive ductal carcinoma,which has cer
作者
张宇
刘梁生
马文娟
韩敏
朱鹰
路红
ZHANG Yu;LIU Liangsheng;MA Wenjuan;HAN Min;ZHU Ying;LU Hong(Department of Breast Imaging,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Tianjin's Clinical Research Center for Cancer,Key Laboratory of Breast Cancer Prevention and Therapy,Tianjin Medical University,Ministry of Education,Key Laboratory of Cancer Prevention and Therapy,Tianjin,Tianjin 300060,China)
出处
《天津医药》
CAS
北大核心
2022年第8期853-858,共6页
Tianjin Medical Journal
基金
国家自然科学基金青年科学基金项目(81801781)
国家自然科学基金资助项目(82072004)。
关键词
乳腺肿瘤
癌
导管
乳腺
早期诊断
超声检查
分子分型
breast neoplasms
carcinoma,ductal,breast
early diagnosis
ultrasonography
molecular subtypes
