| 摘要: |
| 目的 探讨超声造影定量参数结合人类表皮生长因子受体-2（Her-2neu）、原癌基因（CerbB-2）对于肿块型乳腺癌的诊断价值。方法 回顾性分析2017年7月-2020年10月于我院行乳腺超声造影检查，并经术后病理证实为肿块型乳腺癌的患者61例（恶性组）和乳腺良性肿瘤的患者73例（良性组），经造影分析软件得出超声造影定量参数：峰值强度（PI）、上升支斜率（WIS）、达峰时间（TTP）、曲线下面积（AUC1）和梯度（Grad）。采用免疫组织化学染色检测Her-2neu、CerbB-2的表达情况。采用Spearman秩相关分析评价超声造影定量参数与Her-2neu、CerbB-2表达的相关性。采用ROC曲线分析超声造影定量参数结合Her-2neu、CerbB-2对于肿块型乳腺癌诊断的准确度、特异度、敏感度。结果 恶性组与良性组超声造影定量参数对比分析显示， PI、TTP、AUC1和Grad的对比差异有统计学意义（P＜0.05），而WIS的对比中差异无统计学意义（P＞0.05）。与良性组组织对比，恶性组组织中Her-2neu、CerbB-2阳性表达率均显著升高，差异有统计学意义（P＝0.000）。超声造影定量参数PI、TTP、AUC1和Grad与Her-2neu呈正相关，差异有统计学意义（P＜0.05），超声造影定量参数TTP与CerbB-2呈正相关，差异有统计学意义（P＝0.000），其余超声造影定量参数与Her-2neu、CerbB-2表达无相关性。超声造影定量参数结合Her-2neu、CerbB-2对于肿块型乳腺癌的诊断价值优于单独应用超声造影定量参数或Her-2neu、CerbB-2，组间比较差异均有统计学意义（P＜0.05）。结论 超声造影定量参数有助于鉴别诊断乳腺良恶性病变，且与乳腺癌组织中Her-2neu、CerbB-2的表达具有一定相关性，可提高肿块型乳腺癌患者术前和非侵袭性诊断的准确性，为临床治疗提供参考依据。 |
| 关键词: 超声造影 定量参数 Her-2neu CerbB-2 肿块型乳腺癌 |
| DOI： |
| 投稿时间：2020-12-31修订日期：2021-01-28 |
| 基金项目:重庆市卫计委医学科研计划项目(2017MSXM379) |
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| Quantitative parameters of contrast-enhanced ultrasound combined with Her-2neu and CerbB-2 for the diagnosis of lump-type breast cancer |
| Yue Guo-biao |
| (Department of Ultrasonograph,Chongqing Changshou District People''s Hospital,Chongqing,401220) |
| Abstract: |
| Objective：To investigate the diagnostic value of quantitative parameters of contrast-enhanced ultrasound combined with Her-2neu and CerbB-2 for lump-type breast cancer. Methods：Were retrospectively analyzed in July 2017 - October 2020 in our hospital breast ultrasound imaging examination, and confirmed by postoperative pathological type for mass breast cancer (malignant group) and 61 cases of patients with breast benign tumor, 73 cases of patients with (benign group), the imaging analysis software contrast-enhanced ultrasound quantitative parameters: the peak intensity (PI), increase the slope (WIS), tmax (TTP), the area under the curve (AUC1) and gradient (Grad). Immunohistochemical staining was used to analyze the expressions of Her-2neu and CerbB-2.Spearman rank correlation analysis was used to evaluate the correlation between quantitative parameters of CEUS and the expressions of Her-2neu and CerbB-2.Area under the curve (AUC) was adopted to analyze the diagnostic accuracy, specificity and sensitivity of contrast-enhanced ultrasound combined with Her-2neu and CerbB-2 for lump-type breast cancer. Results： Comparison of quantitative parameters of ceus between the malignant group and the benign group showed that the differences of peak intensity (PI), peak time (TTP), area under curve (AUC1) and gradient (Grad) were statistically significant (P < 0.05), while the differences of slope of ascending branch (WIS) were not statistically significant (P > 0.05). Compared with the benign group, the positive expression rates of Her-2neu and CerbB-2 in the malignant group were significantly increased, and the difference was statistically significant (P = 0.000). Contrast-enhanced ultrasound quantitative parameters of the peak intensity (PI), tmax (TTP), the area under the curve (AUC1) and gradient (Grad) was positively related with its Her-2neu, the difference was statistically significant (P < 0.05), ultrasonic imaging quantitative parameter of peak time (TTP) was positively related with CerbB - 2, difference was statistically significant (P = 0.000), the rest of the ultrasonic imaging quantitative parameters and its Her-2neu, CerbB-2 expression has no relevance. The diagnostic value of quantitative parameters of CEUS combined with Her-2neu and CerbB-2 for mass breast cancer is superior to that of quantitative parameters of CEUS alone or Her-2neu and CerbB-2, with statistically significant differences between groups (P < 0.05). Conclusion：Quantitative parameters of CEUS contribute to the differential diagnosis of benign and malignant breast lesions, and are correlated to the expressions of Her-2neu and CerbB-2 in breast cancer tissues, which can improve the accuracy of preoperative and non-invasive diagnosis in patients with lump-type breast cancer and provide reference for clinical treatment. |
| Key words: ultrasound?contrast quantitative?parameter Her-2neu CerbB-2 Lump-type breast cancer Chinese Library Classification |
