目的：探讨乳腺浸润性导管癌（Invasive ductal carcinoma，IDC）的超声征象与分子生物学标记物表达的相关性。方法：回顾性描述经手术病理证实为乳腺IDC的117例患者彩色多普勒超声征象，包括肿块大小、边缘、形态、钙化、后方回声和血流显像分级、淋巴结转移及侵犯周围组织，并采用免疫组化方法检测雌激素受体（Estrogen receptor，ER）、孕激素受体（Progesterone receptor，PR）、人类表皮生长因子受体2（Human epidermal growth factor receptor，HER-2）、Ki67、p53的表达情况，分析其与超声表现的相关性。结果：ER、PR、HER-2、Ki67、p53在乳腺IDC组织的阳性率分别为70.9%、59.0%、66.7%、70.1%、51.3%。乳腺IDC超声表现边缘“毛刺征”与ER、PR表达相关（P＜0.05）；肿块内微小钙化与HER-2、Ki67表达相关（P＜0.05）；后方回声衰减、血流分级2～3级与HER-2、Ki67、p53表达呈正相关，与ER、PR表达水平无明显相关性（P＞0.05）；发生淋巴转移及周围组织浸润与否与ER、PR、HER-2、Ki67、p53表达有相关性（P＜0.05）；而肿块大小、形态与ER、PR、HER-2、Ki67、p53表达无明显相关性（P＞0.05）。Ki67与HER-2、p53与HER-2的表达程度呈正相关（r=0.290，P=0.001；r=0.254，P=0.006）。Ki67与p53表达程度呈正相关（r=0.222，P=0.016）。结论：乳腺IDC超声征象与ER、PR、HER-2、Ki67、p53表达存在相关性，超声征象显示的恶性程度在一定程度上与ER、PR的低表达和HER-2、Ki67、p53的高表达相关，为乳腺癌患者的个性化治疗及预后评估提供指导依据。
Abstract
Objective: To investigate the correlation between ultrasonographic features with expression of biological indicators in breast invasive ductal carcinoma(IDC). Methods: The 117 cases of breast IDC tissues confirmed by pathology were described retrospectively by color Doppler ultrasound signs, including tumor size, edge, shape, distribution of calcification and morphology, rear echo, grade of flowing image, metastasis to lymph node and surrounding tissues invasion. We used immunohistochemical methods to detect the expression of ER, PR, HER-2, Ki67, p53 and analyze their correlations with ultrasonographic features. Results: The positive rate of ER, PR, HER-2, Ki67 and p53 in breast IDC were 70.9%, 59.0%, 66.7%, 70.1%, 51.3% respectively. Edge “glitches” sign of ultrasonographic features had correlation with the expression of ER, PR(P<0.05). The microcalcifications within the mass had correlation with the expression of HER-2, Ki67(P<0.05). The features of rear echo attenuation and flow grade level 2～3 had positive correlation with the expression of HER-2, Ki67, p53, but had no significant correlation with ER, PR(P>0.05). Whether lymph node metastasis and infiltration of surrounding tissue had correlation with the expression of ER, PR, HER-2, Ki67, p53(P<0.05), and tumor size, shape had no significant correlation with ER, PR, HER-2, Ki67, p53(P>0.05). The level of Ki67 and HER-2, p53 and HER-2 were positively correlated(r=0.290, P=0.001; r=0.254, P=0.006). The expression of Ki67 and p53 was positively correlated(r=0.222; P=0.016). Conclusion: There has correlation between ultrasonographic features and molecular biological markers, such as ER, PR, HER-2, Ki67, p53. Malignancy ultrasono-graphic features display a certain extent with the low level of ER, PR and high level of HER-2, Ki67, p53, then provide the guiding basis for individualized treatment and prognosis evaluation of patients with breast cancer.
关键词
乳腺肿瘤 /
生物学 /
超声检查 /
多普勒 /
彩色
Key words
Breast neoplasms /
Biology /
Ultrasonography, Doppler, color
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基金
辽宁省自然科学基金计划（20102138）。
