Ultrasonographic features and immunohistochemical parameters of mucinous Carcinoma of breast
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摘要:
目的 分析乳腺粘液癌的超声图像特征及免疫组化指标,提高诊断粘液癌的准确性。 方法 回顾性分析56例乳腺癌肿块的超声特征(肿块最大径、纵横比、高回声晕、转移情况、弹性评分等)、剪切波速度(SWVmax、SWVratio、SWVmean)及免疫组化检测结果(雌激素受体、孕激素受体、人表皮生长因子受体2、Ki-67),将粘液癌患者作为实验组(n=24),将浸润性导管癌患者作为对照组(n=32),对比两组超声特征及免疫组化指标表达的差异性,并对超声特征及免疫组化指标进行相关性分析。 结果 与浸润性导管癌相比,粘液癌肿块多表现为边界清晰、有高回声晕、后方回声增强、弹性评分 < 4分且BI-RADS分类 < 4b类(χ2=4.419、5.171、6.162、4.743、14.000,P < 0.05),SWVmax及雌激素受体、人表皮生长因子受体2的阳性率在两组中的差异具有统计学意义(t=- 2.069,χ2=4.371、4.051,P < 0.05)。 结论 乳腺粘液癌超声特征及免疫组化指标的表达与浸润性导管癌相比具有一定的差异,可为超声诊断乳腺癌类型及治疗方案的选择提供参考。 Abstract:Objective To analyze the ultrasonographic features and immunohistochemical indexes of mucinous carcinoma of the breast, and improve the accuracy in the diagnosis of mucinous carcinoma. Methods The ultrasonographic features (maximum diameter, aspect ratio, high echo halo, metastasis, elastic score), shear wave velocity (SWVmax, SWVratio, SWVmean) and immunohistochemical detection (ER, PR, HER-2, Ki-67) of 56 cases were analyzed retrospectively. 24 cases with mucinous carcinoma were used as experimental group and 32 cases with invasive ductal carcinoma were used as control group.The differences of ultrasonic features and immunohistochemical indexes between the two groups were compared. The correlation between ultrasonic features and immunohistochemical indexes was analyzed. Results Compared with invasive ductal carcinoma, mucinous carcinoma showed clear boundary, high echo halo, posterior echo enhancement, less than 4 score and BI-RADS classification < 4b (χ2=4.419, 5.171, 6.162, 4.743, 14.000, P < 0.05). The positive rates of SWVmax, ER and HER-2 were significantly different between the two groups (t=-2.069, χ2=4.371, 4.051, P < 0.05). Conclusion Compared with invasive ductal carcinoma, the expression of ultrasound features and immunohistochemical markers in mucinous carcinoma of breast are different, which can provide reference for the diagnosis and treatment of mucinous Carcinoma of breast. -
表 1 粘液癌及浸润性导管癌常规超声特征的比较
Table 1. Comparison of routine ultrasonographic features of mucinous carcinoma and invasive ductal carcinoma[n(%)]
特征 粘液癌 浸润性导管癌 χ2 P 最大径(cm) 0.875 0.350 ≤2 12(37.5) 20(62.5) >2 12(50.0) 12(50.0) 位置 6.017 0.111 内上 6(54.5) 5(45.5) 内下 0(0.0) 0(0.0) 外上 9(29.0) 22(71.0) 外下 6(60.0) 4(40.0) 乳晕区 3(75.0) 1(25.0) 纵横比 1.864 0.172 >1 2(22.2) 7(77.8) ≤1 22(46.8) 25(53.2) 内部回声 1.427 0.232 均匀 0(0.0) 4(100.0) 不均匀 22(44.0) 28(56.0) 后方回声 6.162 0.046 衰减 8(30.8) 18(69.2) 混合 4(33.3) 8(66.7) 增强 12(66.7) 6(33.3) 边界 5.419 0.020 不清晰 9(29.0) 22(71.0) 清晰 15(60.0) 10(40.0) 边缘 0.021 0.884 不规整 20(44.4) 25(55.6) 规整 4(36.4) 7(63.6) 高回声晕 5.171 0.023 无 10(30.3) 23(69.7) 有 14(60.9) 9(39.1) 钙化 1.556 0.212 无 20(47.6) 22(52.4) 有 4(28.6) 10(71.4) 血流 1.641 0.200 0~1级 9(56.3) 7(43.7) 2~3级 15(37.5) 25(62.5) 弹性评分(分) 4.743 0.029 <4 10(66.7) 5(33.3) ≥4 14(34.1) 27(65.9) BI-RADS分类 14.000 < 0.001 <4b 12(85.7) 2(14.3) ≥4b 12(28.6) 30(71.4) 转移情况 0.570 0.450 未转移 18(46.2) 21(53.8) 转移 6(35.3) 11(64.7) 表 2 粘液癌及浸润性导管癌剪切波速度值的比较
Table 2. Comparison of shear wave velocity values between mucinous carcinoma and infiltrating ductal carcinoma (Mean±SD)
乳腺癌类型 VTIQ剪切波速度 SWVmax SWVratio SWVmean 粘液癌(n=8) 5.59±2.25 3.58±2.49 4.21±1.52 浸润性导管癌(n=21) 7.23±1.78 3.73±1.20 4.48±1.31 t -2.069 -0.224 -0.520 P 0.048 0.824 0.607 SWVmax:剪切波速度最大值;SWVratio:病灶与同高度正常腺体的剪切波速度比值;SWVmean:剪切波速度平均值. 表 3 粘液癌及浸润性导管癌免疫组化指标表达的比较
Table 3. Comparison of the expression of immunohistochemical indexes between mucinous carcinoma and invasive ductal carcinoma[n(%)]
病理类型 ER PR HER-2 Ki-67 (+) (-) (+) (-) (+) (-) (+) (-) 粘液癌(n=24) 21(87.5) 3(12.5) 22(91.7) 2(8.3) 5(20.8) 19(79.2) 17(70.8) 7(29.2) 浸润性导管癌(n=32) 20(62.5) 12(37.5) 25(78.1) 7(21.9) 15(46.9) 17(53.1) 25(78.1) 7(21.9) χ2 4.371 1.864 4.051 0.389 P 0.037 0.172 0.044 0.533 ER:雌激素受体;PR:孕激素受体;HER-2:人表皮生长因子受体2. -
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