| 摘要: |
| 目的 探讨乳腺癌超声造影(contrast enhanced ultrasound,CEUS)特征与血管生成拟态(vascular mimicry,VM)的相关性及鉴别诊断价值。 方法 选取我院2015年1月至2018年12月经手术病理证实为乳腺浸润性导管癌患者152例。所有患者术前均行常规超声及CEUS检查,术后病理标本行CD34/PAS 双染色。记录患者临床病理特征(年龄、肿瘤大小、临床分期、是否淋巴结转移)和CEUS特征(均匀性、是否存在灌注缺损、增强强度、增强形态、边界等),采用t检验或Χ2检验分析VM阳性与阴性乳腺肿瘤CEUS特征的差异。采用受试者特性曲线(ROC)分析各显著因素鉴别VM阳性的诊断效能。 结果 本组病例病理确诊VM阳性率为26.3%(40/152)。t检验或Χ2检验结果显示病灶直径＞2 cm、临床分期为Ⅲ期及Ⅳ期、腋窝淋巴结转移与VM阳性相关(P＜0.05)。CEUS结果显示病灶增强形态不规整、边界不清晰、增强模式为快进快退和快进慢退与VM阳性相关(P＜0.05)。其中病灶增强边界不清楚鉴别VM阳性的价值最高,曲线下面积(AUC)为0.764,准确性、敏感性、特异性分别为85.0%、66.7%、90.3%。 结论 CEUS特征与VM阳性存在一定的相关性,CEUS表现为形态不规整、边界不清、快进快出征象可作为鉴别乳腺癌VM阳性的有效辅助手段。 |
| 关键词: 超声 乳腺癌 血管生成拟态 超声造影 |
| DOI： |
| 投稿时间：2019-07-05修订日期：2020-01-07 |
| 基金项目:义乌市科研计划项目(NO.18-3-53) |
|
| The relationships between contrast enhanced ultrasound and vascular mimicry in breast cancer |
| Fan jing |
| (Department of Medical Ultrasound,Yiwu Fuyuan Hospital) |
| Abstract: |
| Objective To analyze the relationships and the differences between the characters of contrast enhanced ultrasound (CEUS) and vascular mimicry (VM) in breast cancer. Method 152 breast cancer patients confirmed as invasive ductal carcinoma by pathology between January 2015 and December 2018 were enrolled. The B mode ultrasound and CEUS were performed before surgery. The CD34/PAS staining were conducted with the specimens after surgery. The clinicopathologic parameters (age, tumor size, clinical stage, axillary lymph node metastasis) and characters of CEUS (enhancement homogeneity, with or without perfusion defect, enhancement degree, enhancement morphology, enhancement margin type, ect) were recorded. t test andΧ2 test were used to analyze the relationship between CEUS characters and VM positive or negative statues. ROC curve was used for analyzing the diagnostic performances of significant factors of VM positive statue. Results The VM positive rate was 26.3% (40/152). The tumors with diameter ＞2 cm, clinical stage of Ⅲ and Ⅳ, and lymph node metastasis were associated with VM positive lesions (P＜0.05). The CEUS characters of tumors with irregular morphology, irregular margin, fast enhancement in the arterial phase and fast disappear in the delayed phases were associated with VM positive lesions (P＜0.05). The irregular margins of the tumors resulted in highest area under the curve (AUC) of 0.764, with the accuracy, sensitivity and specificity of 85.0%, 66.7% and 90.3%, respectively. Conclusions CEUS is relative to VM positive statue. The characters of tumors with irregular morphology, irregular margin, fast enhancement in the arterial phase and fast disappear in the delayed phases suggested the positive statue of VM, which could be a useful supplementary method for differentiating VM positive statue. |
| Key words: ultrasound breast cancer vascular mimicry contrast enhanced ultrasound |
