目的：探讨乳腺癌彩色多普勒超声征象与其细胞蛋白表达指标ER、PR、CerbB-2、Ki-67、P53的相关性及临床意义。方法：经手术病理证实的97例乳腺癌患者进行彩色多普勒超声检查，并对照其细胞蛋白ER、PR、CerbB-2、Ki-67、P53的表达水平，分析两者相关性。结果：97例乳腺癌标本中各细胞蛋白阳性表达率分别为ER（68.04%）、PR（61.86%）、CerbB-2（77.32%）、Ki-67（60.82%）、P53（56.70%）；①在小肿块组中ER、PR阳性表达率高于其对应组阳性表达率，CerbB-2阳性表达率则相反，差异均有统计学意义（P<0.05）。②在内部回声不均匀组中PR、P53阳性表达率高于对应组，差异有统计学意义（P<0.05）。③在毛刺组中ER、PR、CerbB-2、Ki-67、P53阳性表达率均比对应组高，且差异有统计学意义（P<0.05）。④在微小钙化组中CerbB-2、Ki-67、P53的阳性表达率高于无微钙化组，差异有统计学差异（P<0.05）。⑤在富血供组的ER、PR、CerbB-2、Ki-67阳性表达率均高于乏血供组，差异有统计学意义（P<0.05）。⑥在淋巴结转移阳性组的ER、 PR、CerbB-2、P53阳性表达率高于对应组，差异有统计学意义（P<0.05）。结论：乳腺癌超声声像图表现与病理组织学变化密切相关，肿块的超声形态特点对细胞蛋白表达有提示作用，其中病灶的毛刺征、微钙化、富血供及淋巴结转移征象与其对应的细胞蛋白是恶性度的强预测指标，联合应用超声征象与分子生物学指标对评估乳腺癌早期治疗及预后有重要临床价值。
Abstract
Objective: To explore the correlation between color Doppler ultrasound findings and the expression levels of ER, PR, CerbB-2, Ki-67 and P53 in breast cancer and the clinical significance. Methods: Ninety-seven patients of breast cancer confirmed pathologically were examined by color Doppler ultrasound and the expression levels of ER, PR, CerbB-2, Ki-67 and P53 was analyzed and correlated with the ultrasound findings. Results: In the 97 cases of breast cancer, the positive rates of ER, PR, CerbB-2, Ki-67, and P53 were 68.04%, 61.86%, 77.32%, 60.82% and 56.70%, respectively. ①In the group of small masses, the positive expression rates of ER and PR were higher than those in their corresponding group, but the CerbB-2 was opposite, with statistically significant differences(P<0.05). ②In the group with uniform internal echo, the positive expression rates of PR and P53 were higher than those in the corresponding group, with statistically significant differences(P<0.05). ③In the group with spiculation, the positive expression rates of ER, PR, CerbB-2, Ki-67, P53 were higher than those in the corresponding group, and the differences were statistically significant(P<0.05).④In microcalcification group, the positive expression rates of ER, PR, CerbB-2, Ki-67, P53 were higher than those in no microcalcification group, with statistically significant differences(P<0.05). ⑤In the group with rich blood supply, the positive expression rates of ER, PR, CerbB-2, Ki-67 were higher than those in the group lack of blood supply, with statistically significant differences(P<0.05). ⑥In the group with positive lymph nodes, the positive expression rates of ER, PR CerbB-2, P53 were higher than those in the corresponding group, with statistically significant differences(P<0.05). Conclusion: Ultrasound findings are closely related to the pathology of breast cancer. Ultrasonic morphological characteristics of cancer might predict the expression of some types of proteins. The level of the proteins and the ultrasound features, including spiculation, microcalcification, blood supply and lymph node metastasis, are effective indicators of the malignancy grade. Combination of the ultrasound features and molecular biomarkers can play a crucial role in early evaluating of treatment and prognosis of breast cancer.
关键词
乳腺肿瘤；超声检查 /
多普勒 /
彩色
Key words
Breast neoplasms /
Ultrasonography, Doppler, color
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