早期肿块型乳腺浸润性导管癌超声征象与分子分型的相关性研究

doi:10.11958/20220230

天津医药 ›› 2022, Vol. 50 ›› Issue (8): 853-858.doi: 10.11958/20220230

早期肿块型乳腺浸润性导管癌超声征象与分子分型的相关性研究

张宇(), 刘梁生, 马文娟, 韩敏, 朱鹰, 路红()

天津医科大学肿瘤医院乳腺影像诊断科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床医学研究中心,乳腺癌防治教育部重点实验室,天津市肿瘤防治重点实验室（邮编300060）

收稿日期:2022-02-24 修回日期:2022-06-19 出版日期:2022-08-15 发布日期:2022-08-12
通讯作者: 路红 E-mail:quickduck@sina.com;honglu@tmu.edu.cn
作者简介:张宇（1984）,女,住院医师,主要从事乳腺影像诊断方面研究。E-mail： quickduck@sina.com
基金资助:
国家自然科学基金青年科学基金项目(81801781);国家自然科学基金资助项目(82072004)

Correlation between ultrasonographic features and molecular subtypes of early mass-type breast invasive ductal carcinoma

ZHANG Yu(), LIU Liangsheng, MA Wenjuan, HAN Min, ZHU Ying, LU Hong()

Department of Breast Imaging, Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Tianjin’s Clinical Research Center for Cancer; Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education; Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin 300060, China

Received:2022-02-24 Revised:2022-06-19 Published:2022-08-15 Online:2022-08-12
Contact: LU Hong E-mail:quickduck@sina.com;honglu@tmu.edu.cn

张宇, 刘梁生, 马文娟, 韩敏, 朱鹰, 路红. 早期肿块型乳腺浸润性导管癌超声征象与分子分型的相关性研究[J]. 天津医药, 2022, 50(8): 853-858.

ZHANG Yu, LIU Liangsheng, MA Wenjuan, HAN Min, ZHU Ying, LU Hong. Correlation between ultrasonographic features and molecular subtypes of early mass-type breast invasive ductal carcinoma[J]. Tianjin Medical Journal, 2022, 50(8): 853-858.

摘要/Abstract

摘要：

目的通过分析早期肿块型乳腺浸润性导管癌的超声征象与分子分型的相关性,探讨超声征象对早期肿块型乳腺浸润性导管癌分子分型的诊断价值。方法纳入298例术前诊断为Ⅰ~Ⅱ期乳腺癌,且乳腺超声检查显示为肿块型病变,并经手术病理证实为乳腺浸润性导管癌的患者。比较此类乳腺癌不同分子分型的超声征象差异,Logistic回归分析Luminal型、HER-2过表达型和三阴型的影响因素。结果 298例中有Luminal A型26例、Luminal B型178例、HER-2过表达型54例、三阴型40例。不同分子分型的乳腺癌患者在发病年龄、直径、边缘、形态、内部钙化、后方回声等方面的差异有统计学意义（P<0.05）;腋下淋巴结转移、生长方向、回声、血流信号间的差异无统计学意义（P>0.05）。形态不规则（OR=1.206,95%CI：1.039~1.400,P<0.05）、边缘不光整（OR=1.490,95%CI：1.224~1.814,P<0.05）是Luminal型的独立危险因素;后方回声增强（OR=0.674,95% CI：0.603~0.752,P<0.05）是其独立保护因素。边缘不光整（OR=0.688,95%CI：0.564~0.838,P<0.05）是HER-2过表达型的独立保护因素。形态不规则（OR=0.820,95%CI：0.728~0.923,P<0.05）、后方回声衰减（OR=0.714,95%CI：0.644~0.792,P<0.05）、后方回声无改变（OR=0.723,95%CI：0.662~0.791,P<0.05）、后方混合回声（OR=0.790,95%CI：0.638~0.978,P<0.05）是三阴型的独立保护因素。结论超声征象能为早期肿块型乳腺浸润性导管癌的分子分型诊断提供影像学依据,具有一定的临床意义。

关键词: 乳腺肿瘤, 癌,导管,乳腺, 早期诊断, 超声检查, 分子分型

Abstract:

Objective To investigate the diagnostic value of ultrasonic signs to molecular typing of early mass-type breast invasive ductal carcinoma by analyzing the correlation between ultrasonographic features and molecular types of early mass-type breast invasive ductal carcinoma. Methods A total of 298 patients with stage Ⅰ-Ⅱ breast cancer who were diagnosed by ultrasonography as mass-type lesions before operation and were confirmed as breast invasive ductal carcinoma by surgical pathology were retrospective included. The differences of ultrasonographic features and molecular subtypes were compared and analyzed. The influencing factors of Luminal type, HER-2 overexpression type and triple-negative type were analyzed by Logistic regression. Results Among 298 patients, 26 cases were Luminal A type, 178 cases were Luminal B type, 54 cases were HER-2 overexpression type and 40 cases were triple negative type. There were significant differences in age of onset, tumor diameter, margin, morphology, internal calcification and posterior echo between patients with different molecular types (P<0.05). There were no significant differences in axillary lymph node metastasis, growth direction, echo and blood flow signal (P>0.05). Irregular shape (OR=1.206, 95%CI: 1.039-1.400, P<0.05) and rough edge (OR=1.490, 95%CI: 1.224-1.814, P<0.05) were independent risk factors for Luminal type. The enhancement in posterior echo was the independent protective factor for Luminal type (OR=0.674, 95%CI: 0.603-0.752, P<0.05). Rough edge was the independent protective factor for HER-2 overexpression type (OR=0.688, 95%CI: 0.564-0.838, P<0.05). Irregular shape (OR=0.820, 95%CI: 0.728-0.923, P<0.05), attenuation in posterior echo (OR=0.714, 95%CI: 0.644-0.792, P<0.05), no change in posterior echo (OR=0.723, 95%CI: 0.662-0.791, P<0.05) and mixed echo in posterior echo (OR=0.790, 95%CI: 0.638-0.978, P<0.05) were independent protective factors for triple-negative type. Conclusion The ultrasonographic features can provide a basis for molecular typing of early mass-type breast invasive ductal carcinoma, which has certain clinical significance.

Key words: breast neoplasms, carcinoma, ductal, breast, early diagnosis, ultrasonography, molecular subtypes

中图分类号:

图/表 8

表1 不同分子分型早期肿块型乳腺浸润性导管癌发病年龄及超声征象的比较

Tab. 1 Comparison of age of onset and ultrasonographic characteristics of early mass-type breast invasive ductal carcinoma between different molecular subtypes

图1 不同分子分型早期肿块型乳腺浸润性导管癌超声二维灰阶图像对比图 A：Luminal A型,形态不规则、边缘不光整、低回声、后方回声无改变的肿块;B：Luminal B型,形态不规则、边缘不光整、低回声、后方回声无改变的肿块;C：HER-2过表达型,形态不规则、边缘不光整、低回声、内部可见多发点状钙化、后方回声无改变的肿块;D：三阴型,形态规则（分叶状）、边缘欠光整、低回声、后方回声增强的肿块。

Fig.1 Comparison of ultrasonographic two-dimensional gray scale images of early mass-type breast invasive ductal carcinoma between different molecular subtypes

表2 Luminal型与非Luminal型发病年龄及超声征象的比较

Tab.2 Comparison of age of onset and ultrasonographic characteristics between Luminal type and non-Luminal type

表3 Luminal型超声征象的多因素Logistic回归分析

Tab.3 Logistic regression analysis of multivariate factors for ultrasonographic characteristics of Luminal type

表4 HER-2过表达型与非HER-2过表达型发病年龄及超声征象的比较

Tab.4 Comparison of age of onset and ultrasonographic characteristics between HER-2 overexpression type and non-HER-2 overexpression type

表5 HER-2过表达型超声征象的多因素Logistic回归分析

Tab.5 Logistic regression analysis of multivariate factors for ultrasonographic characteristics of HER-2 overexpression type

表6 三阴型与非三阴型发病年龄及超声征象的比较

Tab.6 Comparison of age of onset and ultrasonographic characteristics between triple-negative type and non-triple-negative type

表7 三阴型超声征象的多因素Logistic回归分析

Tab.7 Logistic regression analysis of multivariate factors for ultrasonographic characteristics of triple-negative type

参考文献 17

[1]	ELLIS I O, SCHNITT S J, SASTRE-GARAU X, et al. Invasive breast carcinoma,In:TAVASSOLI FA,DEVILCE P,eds. Tumours of the breast and female genital organs[M]. Lyon:IARC press, 2013:13-59.
[2]	STUART JS, LAURA CC. 乳腺病理活检解读[M]. 黄文斌,薛德彬,译. 北京: 北京科学技术出版社, 2010:238-284.
	STUART JS, LAURA CC. Biopsy interpretation of the breast[M]. HUANG W B,XUE D B,Translated. Beijing: Beijing Science and Technology Publishing House, 2010:238-284.
[3]	American College of Radiology. Breast imaging reporting and data system(BI-RADS)ultrasound[S]. Reston, Va: American College of Radiology, 2013.
[4]	GOLDHIRSCH A, WINER E P, COATES A S, et al. Personalizing the treatment of women with early breast cancer:highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013[J]. Ann Oncol, 2013, 24(9):2206-2223. doi: 10.1093/annonc/mdt303.
[5]	康佳, 吴桐, 张蕾, 等. 不同分子分型乳腺癌的多模态超声特征和临床病理对照研究[J]. 中华超声影像学杂志, 2020, 29(4):330-336.
	KANG J, WU T, ZHANG L, et al. Comparative study of multimodal ultrasonographic features and clinicopathological appearances of breast cancer with different molecular subtypes[J]. Chin J Ultrasonogr, 2020, 29(4):330-336. doi: 10.3760/cma.j.cn131148-20190926-00591.
[6]	李薇, 平学军, 刘宇豪, 等. MRI影像组学特征预测乳腺癌分子分型的价值[J]. 临床放射学杂志, 2021, 40(9):1709-1714.
	LI W, PING X J, LIU Y H, et al. Value of MRI imaging features in predicting molecular typing of breast cancer[J]. China Academic Journal, 2021, 40(9):1709-1714. doi: 10.13437/j.cnki.jcr.2021.09.012.
[7]	郭玉萍, 裴书芳, 刘娟娟, 等. 不同分子亚型非特殊型浸润性乳腺癌超声特征[J]. 中国医学影像技术, 2019, 35(1):82-85.
	GUO Y P, PEI S F, LIU J J, et al. Ultrasonographic features of different molecular subtypes of no specific type invasive breast carcinoma[J]. Chin J Med Imaging Technol, 2019, 35(1):82-85. doi: 10.13929/j.jssn.1003-3289.2019.06.134.
[8]	吴芳, 成静, 曹春丽, 等. 不同分子分型乳腺癌超声弹性特征[J]. 中国医学影像技术, 2020, 36(7):1017-1021.
	WU F, CHENG J, CAO C L, et al. Ultrasonic elastic characteristics of breast cancers with different molecular subtype[J]. Chin J Med Imaging Technol, 2020, 36(7):1017-1021. doi: 10.13929/j.jssn.1003-3289.2020.07.017.
[9]	陈洋, 张艳, 于瑞娜. 乳腺浸润性导管癌的超声特征及其与分子分型的相关性[J]. 现代肿瘤医学, 2020, 28(10):1739-1743.
	CHEN Y, ZHANG Y, YU R N, et al. Relationship between ultrasonic features and molecular typing in invasive ductal carcinoma of breast[J]. Modern Oncology, 2020, 28(10):1739-1743. doi: 10.3969/j.jssn.1672-4992.2020.10.029.
[10]	唐恩红, 杨少玲, 王凤翎, 等. 分子亚型乳腺癌的超声特征对照研究[J]. 中国超声医学杂志, 2022, 38(1):22-25.
	TANG E H, YANG S L, WANG F L, et al. Comparative study on ultrasonic characteristics of breast cancer[J]. Chinese J Ultrasound Med, 2022, 38(1):22-25.
[11]	WANG D, ZHU K, TIAN J, et al. Clinicopathological and ultrasonic features of triple-negative breast cancers: a comparison with hormone receptor-positive/human epidermal growth factor receptor-2-negative breast cancers[J]. Ultrasound Med Biol, 2018, 44(5):1124-1132. doi: 10.1016/j.ultrasmedbio.2018.01.013.
[12]	岳林先. 实用浅表器官和软组织超声诊断学[M]. 北京: 人民卫生出版社, 2011:278-279.
	YUE L X. Practical ultrasound diagnosis of superficial organs and soft tissues[M]. Beijing: People´s Health Publishing House, 2011:278-279.
[13]	SUN L, YU D H, SUN S Y, et al. Expressions of ER,PR,HER-2,COX-2,and VEGF in primary and relapsed/metastatic breast cancers[J]. Cell Biochem Biophys, 2014, 68(3):511-516. doi: 10.1007/s12013-013-9729-y.
[14]	KONDOH M, OHGA N, AKIYAMA K, et al. Hypoxia-induced reactive oxygen species cause chromosomal abnormalities in endothelial cells in the tumor microenvironment[J]. PLoS One, 2013, 8(11):e80349. doi: 10.1371/journal.pone.0080349.
[15]	FITZGIBBONS P L, PAGE D L, WEAVER D, et al. Prognostic factors in breast cancer. College of American Pathologists Consensus Statement 1999[J]. Arch Pathol Lab Med, 2000, 124(7):966-978. doi: 10.5858/2000-124-0966-PFIBC.
[16]	王琰娟, 米成嵘, 王文. 经皮下注射超声造影对不同分子分型乳腺癌腋窝淋巴结转移的诊断价值[J]. 中国超声医学杂志, 2013, 29(10):890-893.
	WANG Y J, MI C R, WANG W. The diagnostic value of subcutaneous of ultrasound contrast agents through in axillary lymph node metastasis of breast cancer patients[J]. Chinese J Ultrasound Med, 2013, 29(10):890-893. doi: 10.3969/j.jssn.1002-0101.2013.10.008.
[17]	朱庆莉, 姜玉新, 孙强, 等. 乳腺癌彩色多普勒血流显像的多因素分析[J]. 中华超声影像学杂志, 2006, 15(2):109-113.
	ZHU Q L, JIANG Y X, SUN Q, et al. Assessment of the breast cancer vascularity by color doppler sonography[J]. Chin J Ultrasonogr, 2006, 15(2):109-113. doi: 10.3760/j.jssn:1004-4477.2006.02.009.

早期肿块型乳腺浸润性导管癌超声征象与分子分型的相关性研究

Correlation between ultrasonographic features and molecular subtypes of early mass-type breast invasive ductal carcinoma

引用本文

RichHTML

PDF (PC)

可视化

摘要/Abstract

使用本文

图/表 8

参考文献 17

相关文章 15

编辑推荐

Metrics

本文评价

[1]	朱刚明, 董永德, 朱瑞婷, 谭源满, 陶娟, 刘晓, 陈德成, 杨概. 磁共振弛豫时间定量成像预测乳腺浸润性导管癌分子亚型的价值[J]. 天津医药, 2024, 52(7): 770-774.
[2]	陈芷彦, 伍秋苑, 邓裕华, 周丹. 类器官技术在乳腺癌研究中的现状及应用[J]. 天津医药, 2024, 52(6): 668-672.
[3]	刘丹阳, 李永涛, 张海燕, 李林, 刘洋, 沈雷. 乳腺癌细胞条件培养基对骨髓间充质干细胞生物学行为的影响[J]. 天津医药, 2024, 52(5): 454-458.
[4]	徐杨, 袁宇, 高金妹. 超声检查对骨折患者下肢深静脉漂浮血栓脱落的诊断意义[J]. 天津医药, 2024, 52(5): 548-551.
[5]	谢皓冉, 李一浩, 刘成, 夏瑜婷, 裘圣蕾, 熊斌, 冯其贞. 医保DIP支付背景下乳腺癌腋窝淋巴结转移的预测因素探讨[J]. 天津医药, 2024, 52(11): 1193-1196.
[6]	刘桂莹, 刘立志, 杨宗梅. 胎盘生长因子与晚发型子痫前期患者超声血流参数的关系及对妊娠结局的影响[J]. 天津医药, 2024, 52(10): 1069-1074.
[7]	王众, 赵静雯, 王天驰, 唐缨. 超声影像组学在肾炎组织学分型中的应用价值[J]. 天津医药, 2024, 52(10): 1100-1105.
[8]	吴海啸, 马文娟, 李之珺, 张超. 基于放射组学评估胸肌指数与乳腺癌骨转移患者预后关系的研究[J]. 天津医药, 2023, 51(9): 1007-1010.
[9]	杨娉娉, 张景, 陈红宇, 张淼, 周定安, 方文. 抑癌基因SASH1在乳腺癌中结合Vimentin并负性调节Vimentin的表达[J]. 天津医药, 2023, 51(9): 904-908.
[10]	赵津津, 王振宇, 马贞秀. circRASSF2靶向miR-1343-3p对乳腺癌MDA-MB-231细胞增殖和凋亡的影响[J]. 天津医药, 2023, 51(7): 713-717.
[11]	王天驰, 王众, 牛宁宁, 唐缨. 超声影像组学对移植肾实质性病变鉴别诊断的价值[J]. 天津医药, 2023, 51(6): 653-657.
[12]	徐杨, 袁宇, 万鑫, 王丽娟. 胎囊平均直径在剖宫产瘢痕妊娠清宫术中大出血风险评估中的应用价值[J]. 天津医药, 2023, 51(5): 549-552.
[13]	滕丽峰, 陈茜茜, 叶丛, 黄玉冰. 血清Sestrin2在急性ST段抬高型心肌梗死中的表达及其与缺血再灌注损伤的关系[J]. 天津医药, 2023, 51(3): 303-306.
[14]	许莉敏, 谢燕. 外周血单核细胞DNMT1及血清IL-6在糖尿病肾脏病中的表达及意义[J]. 天津医药, 2023, 51(2): 194-197.
[15]	陈俊, 郑锦豪, 陈家良, 陈博. 阿尔茨海默病患者血清GGT、CTHRC1表达水平检测及临床意义[J]. 天津医药, 2023, 51(2): 216-220.