乳腺癌超声影像学表现与分子生物学相关性研究

摘要

目的 探讨乳腺癌超声影像学表现与分子生物学相关性.方法 选择2008年10月-2009年10月我院乳甲外科105例乳腺浸润性导管癌患者为研究对象.患者均于术前行高频超声检查,重点观察肿块形态、边缘、后方回声、微小钙化、内部血流以及腋窝淋巴结.以病理组织学结果做对照.术后标本测定癌细胞雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(CerbB-2)的表达情况,分析它们与超声影像学表现间的关系.结果 105例浸润性导管癌中,形态不规则、边缘毛刺征与ER、PR表达呈正关联(P＜0.05＝,OR分别为7 67和6 07,7 38和2 45;强回声晕、微小钙化、后方回声衰减、腋窝淋巴结肿大、血流分级Ⅱ～Ⅲ级与ER、PR表达均无关联(P＞0.05);肿块微小钙化、血流分级Ⅱ～Ⅲ级与CerbB-2阳性表达间呈正关联(P＜0.05＝,OR分别为4 42和14 97;而形态不规则、边缘毛刺征、强回声晕、后方回声衰减、腋窝淋巴结肿大与CerbB-2表达均无关联(P＞0.05).结论 乳腺癌超声影像学表现与分子生物学指标(ER、PR和CerbB-2)间存在一定相关性,据此可对癌肿的生物学行为和预后进行评估,为临床治疗方案选择提供依据.%Objective To investigate the correlations among ultrasonographic features, pathology, and molecular biology of breast cancer. Methods High frequency ultrasonography was performed in 105 patients from out hospital between Oct 2008 and Oct 2009 with invasive ductal carcinoma ( IDC ) of breast preoperatively. Shape, edge, behind echo, micro calcification , inner blood flow, and axillary lymph nodes were particularly observed, with the results compared with that from pathological examinations. The expression of estrogen receptor ( ER ), progesterone receptor ( PR ), CerbB - 2 were measured postopera-tively, with the relationship between immunohistochemical pathologic results and ultrasonographic features analyzed. Results Among the 105 cases of invasive ductal carcinoma ( IDC ), ER and PR positive expression were positively correlated with the irregular shape and spiculated margins of breast cancer [ OR were accordingly 7. 67 and 6. 07 , 7. 38 and 2. 45 ( P ＜0. 05 ) ]; neither ER and PR positive expression was positively correlated with the hyperechoic halo, posterior attenuation, micro calcification, grade Ⅱ -Ⅲ blood flow, and enlarged axillary lymph nodes ( P ＞0. 05 ) . CerbB -2 positive expression was positively correlated with micro calcification and grade Ⅱ -Ⅲ blood flow [ OR were accordingly 4. 42 and 14. 97 ( P ＜0. 05 ) ] and wasn' t correlated with irregular shape, spiculated margins, hyperechoic halo, posterior attenuation, and enlarged axillary lymph nodes ( P＞0. 05 ). Conclusion Correlations exist between ultrasonographic features and molecular biology indicators in breast cancer. The biologic behavior and prognosis of the breast cancer can be assessed according to ultrasonographic features.