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不同分子分型乳腺癌患者多模态超声成像特征分析

Analysis of multimodal ultrasound imaging characteristics in patients with different molecular subtypes of breast cancer

    摘要
  • 摘要:
    目的 分析不同分子分型乳腺癌患者的多模态超声成像特征。
    方法 回顾性收集85例乳腺癌患者的病历资料, 根据免疫组织化学结果分为Luminal A型12例、Luminal B型35例、HER2型21例和三阴型17例，患者均接受常规超声、彩色多普勒超声、超声弹性成像及超声造影检查。分析多模态超声特征与乳腺癌分子分型的关系及其诊断价值。
    结果 常规超声及彩色多普勒超声检查结果显示, 4种分子分型乳腺癌病灶边缘特征比较，差异有统计学意义(P < 0.05)。超声弹性成像检查结果显示, HER2型和三阴型的最大弹性模量(Emax)水平均分别高于Luminal A型、Luminal B型, Luminal B型、HER2型和三阴型的与正常组织弹性模量比值(Eratio)水平均高于Luminal A型, Luminal B型的Eratio水平低于HER2型，差异有统计学意义(P < 0.05)。超声造影检查结果显示, 4种分子分型乳腺癌病灶的增强水平、灌注缺损特征以及峰值强度(IMAX)、达峰时间(TTP)、增强时间(AT)比较，差异有统计学意义(P < 0.05)。多因素Logistic回归分析显示，病灶边缘特征、Emax、Emin、Emean、Eratio、IMAX、TTP及AT是乳腺癌分子分型的独立影响因素(P < 0.05)。受试者工作特征曲线分析显示，多模态超声成像特征(联合指标)诊断乳腺癌分子分型的曲线下面积和敏感度显著大于各单独指标(P < 0.05)。
    结论 不同分子分型乳腺癌的二维超声、彩色多普勒、超声弹性成像及超声造影检查结果存在差异，多模态超声成像特征对乳腺癌分子分型具有较高的诊断价值。

     

    Abstract:
    Objective To analyze the multimodal ultrasound imaging characteristics in patients with different molecular subtypes of breast cancer.
    Methods The medical records of 85 patients with breast cancer were retrospectively collected and classified into 12 cases of Luminal A, 35 cases of Luminal B, 21 cases of HER2, and 17 cases of triple-negative breast cancer based on immunohistochemical results. All patients underwent conventional ultrasound, color Doppler ultrasound, ultrasound elastography, and contrast-enhanced ultrasound. The relationship between multimodal ultrasound characteristics and breast cancer molecular subtypes and their diagnostic value were analyzed.
    Results Conventional ultrasound and color Doppler ultrasound results showed statistically significant differences in the margin characteristics of breast cancer lesions among the four molecular subtypes(P < 0.05). Ultrasound elastography results revealed that the maximum elastic modulus (Emax) levels of HER2 and triple-negative subtypes were higher than those of Luminal A and Luminal B, respectively. The ratios of elastic modulus to normal tissue (Eratio) for Luminal B, HER2, and triple-negative subtypes were higher than that of Luminal A, and the Eratio level of Luminal Bwas lower than that of HER2 (P < 0.05). Contrast-enhanced ultrasound results showed statistically significant differences in enhancement levels, perfusion defects, and peak intensity (IMAX), time to peak (TTP), and augmentation time (AT) among the four molecular subtypes of breast cancer lesions (P < 0.05). Multivariate Logistic regression analysis showed that margin characteristics, Emax, Emin, Emean, Eratio, IMAX, TTP, and AT were independent influencing factors for breast cancer molecular subtypes (P < 0.05). Receiver operating characteristic curve analysis showed that the area under the curve and sensitivity of multimodal ultrasound imaging characteristics (combined indicators) for diagnosing breast cancer molecular subtypes were significantly greater than those of individual indicators (P < 0.05).
    Conclusion There are differences in two-dimensional ultrasound, color Doppler ultrasound, ultrasound elastography, and contrast-enhanced ultrasound results among different molecularsubtypes of breast cancer. Multimodal ultrasound imaging characteristics have high diagnostic value for breast cancer molecular subtypes.

     

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