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目的探讨乳腺癌超声及超声造影表现特征与生物学预后因子之间的相关性。方法选择2007年11月至2014年12月在南京医科大学附属无锡人民医院行原发性乳腺癌手术患者239例,均为单发病灶。患者年龄22~84岁,中位年龄47岁。术前行超声及超声造影检查,根据超声乳腺影像报告和数据系统(BI-RADS)描述乳腺癌的超声及超声造影表现。术后检测雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(HER-2)及Ki67的表达情况。采用Spearman等级相关和二元Logistic回归统计学方法分析与超声及超声造影表现的相关性。结果乳腺癌的毛刺征、微钙化、周边高回声晕、肿块形态及超声造影增强方式与各预后因子间的相关性无统计学意义(P>0.05)。乳腺癌后方回声衰减是ER阳性表达的预测因素(P<0.05)。乳腺癌直径>2 cm是HER-2、Ki67表达阳性的预测因素(P<0.05);乳腺癌超声造影表现为早增强、晚消退是HER-2表达阳性的预测因素(P<0.05)。结论乳腺癌超声及超声造影表现与其预后因子之间存在一定相关性,为术前无创评估乳腺癌预后提供了可能。
Objective To investigate the correlation between the features of ultrasound and contrast-enhanced ultrasound and the biological prognostic factors of breast cancer. Methods From November 2007 to December 2014, 239 patients with primary breast cancer who underwent surgery in Wuxi People’s Hospital Affiliated to Nanjing Medical University were selected as single lesions. Patients aged 22 to 84 years, the median age of 47 years. Preoperative ultrasound and contrast-enhanced ultrasound were used to characterize breast ultrasound and contrast-enhanced ultrasound according to the Breast Imaging Report and Data System (BI-RADS). Postoperative estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2) and Ki67 expression were detected. Spearman rank correlation and binary logistic regression were used to analyze the correlation with ultrasound and CEUS. Results There was no significant correlation between breast cancer with spiculation sign, micro-calcification, peripheral hyperechoic echocardiography, tumor morphology and contrast-enhanced ultrasound and each prognostic factor (P> 0.05). The posterior echo attenuation in breast cancer was a predictor of ER-positive expression (P <0.05). The diameter of breast cancer> 2 cm was the predictor of positive expression of HER-2 and Ki67 (P <0.05). The contrast-enhanced ultrasound was the predictor of breast cancer and the late regression was the predictor of HER-2 positive expression (P <0.05). Conclusion There is a certain correlation between the manifestations of ultrasound and contrast-enhanced ultrasound in breast cancer and their prognostic factors, which provides a possibility for preoperative non-invasive assessment of the prognosis of breast cancer.