摘要
目的:探讨不同大小乳腺浸润性导管癌(IDC)的常规超声、声触诊组织成像和定量分析(VTIQ)、超声造影超声特征及免疫指标的差异.方法:回顾性分析2017年-2022年5月在本院经病理证实的106例IDC患者的多模态超声和临床资料.根据肿块大小,将患者分为＞2 cm组(55例)和≤2 cm组(51例).分析两组之间肿瘤的常规超声特征(位置、纵横比、后方回声衰减、边缘毛刺征、Ad-ler血流分级)、VTIQ指标[剪切波速度最大值(SWVmax)、最小值(SWVmin)、周边平均值(SWV周边AVG)、肿瘤与同切面正常腺体SWV最大值的比值(maxSWVR肿瘤/正常乳腺)、最大值与最小值的比值SWVRmax/min)]和超声造影特征(增强程度、增强速度、增强顺序、病灶边缘放射状汇聚、灌注缺损和增强后病灶范围有无增大)的差异,及其与肿瘤免疫组化指标(ER、PR、Her-2、Ki-67)的相关性.结果:两组之间病变位置(x2=6.937,P=0.031)、Adler 血流分级(x2=9.456,P=0.002)、SWV 周边 AVG(Z=-2.504,P=0.012)、maxSWVR肿瘤/正常乳腺(Z=-2.545,P=0.011)、SWVRmax/min(Z=-2.469,P=0.014)、增强强度(x2=3.918,P=0.048)、增强后放射状汇聚(x2=10.403,P=0.001)、增强后病灶面积增大与否(x2=8.289,P=0.004)及Ki-67水平(x2=5.213,P=0.022)的差异均具有统计学意义.Adler血流分级Ⅱ～Ⅲ级、增强后病灶边缘放射状汇聚、增强后病灶面积增大、高SWV周边AVG、高SWVRmax/min、高maxSWVR肿瘤/正常乳腺乳腺IDC肿块大小呈正相关.结论:不同直径的乳腺浸润性导管癌(以2 cm为阈值时)的多模态超声特征存在一定差异,可以为临床及超声医师的术前诊断提供参考依据.
Abstract
Objective:The aim of this study was to explore the differences of immune parameters and multimodal ultrasound characteristics including conventional ultrasound,virtual touch tissue ima-ging and quantification(VTIQ)and contrast-enhanced ultrasound(CEUS)between different sizes of invasive breast ductal carcinoma(IDC).Methods:Multimodal ultrasound and clinical data of 106 pa-tients with pathologically confirmed IDC in our hospital from 2017 to May 2022 were retrospectively analyzed.According to the tumor size,the patients were divided into＞2cm group(55 cases)and 2cm group(51 cases).Conventional ultrasound features(location,aspect ratio,rear echo attenuation,edge burr sign,Adler blood flow grading),VTIQ parameters[(maximum and minimum of shear wave velocity(SWVmax,SWVmin),average SWV at peripheral area of tumor(SWVper-AVG),ratio of tumor SWVmax to SWVmax of normal breast tissue at the same plane(maxSWVRtumor/breast),ratio of SWVmax to SWVmin(SWVRmax/min)],and contrast-enhanced ultrasound features(enhancement intensity,enhance-ment speed,enhancement sequence,radial convergence,perfusion defect,area increase or not after en-hancement),and their correlation with immunohistochemical indices of tumor(ER,PR,Her-2 and Ki-67).Results:There were significant differences between＞2cm group and ≤2cm group in the tumor lo-cation(x2=6.937,P=0.031),Adler blood flow classification(x2=9.456,P=0.002),SWVper-AVG(Z=-2.504,P=0.012),maxSWVRtumor/breast(Z=-2.545,P=0.011),SWVmax/min(Z=-2.469,P=0.014),reinforcement strength(x2=3.918,P=0.048),radial convergence after enhancement(x2=10.403,P=0.001),range change after enhancement(x2=8.289,P=0.004)and Ki-67(x2=5.213,P=0.022).The Adler blood flow classification of grade Ⅱ～Ⅲ,marginal radiation convergence after enhance-ment,increased lesion area after enhancement high SWVper-AVG,high SWVRmax/min and high maxSWVRtumor/breast were positively correlated with size of IDC,respectively.Conclusion:This research highlights the differences in multimodal ultrasound features of invasive ductal carcinoma of the breast with different diameters(at a threshold of 2cm),offering valuable insights for both clinical and ultra-sound-based preoperative diagnosis of breast tumors.
基金项目
国家自然科学基金(82060318)
国家自然科学基金(81860498)
国家自然科学基金(81560433)
中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2020-PT330-003)
兵团科技计划项目(2022CB002-04)
石河子大学自然科学基金(ZZZC2023035)
石河子大学医学院第一附属医院青年基金(QN202126)
石河子大学医学院第一附属医院青年基金(QN202107)
NETL
NSTL
万方数据