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不同分子分型乳腺癌的超声征象及热层析特征

The Characteristics of Ultrasonography and Thermal Tomography in Various Molecular Subtypes of Breast Cancer

  • 摘要:
      目的  探讨乳腺癌超声及热层析成像的影像学特征及与其分子分型的相关性。
      方法  回顾性分析2014年1月至2017年6月在四川大学华西医院就诊,相关检查资料完整、且有明确病理结果证实的女性乳腺癌患者404例,根据各免疫标志物的表达将乳腺癌病理分子分型分为Luminal A like型、Luminal B like型、人表皮因子生长受体-2(HER-2)过表达型和Basal like型,分析肿块超声BI-RADS征象、热层析曲线特征与病理分子分型结果的相关性。
      结果  形态规则、边缘清晰、后方回声增强的乳腺癌病灶更多见于Basal like型;HER-2过表达型乳腺癌病灶较其他亚型更容易出现微钙化;Luminal A like型乳腺癌热层析曲线走行多贴近30°,HER-2过表达型及Basal like型乳腺癌热层析曲线走行多见于30°~45°间;肿块纵横比≥1以及出现区域淋巴结转移的征象并不能作为区分各个亚型的诊断指标。
      结论  乳腺癌分子亚型具有一定的超声、热层析成像等相关影像学特征,但仍缺乏足够清晰的辨别特征。

     

    Abstract:
      Objective  To explore the relationship between the imaging features of ultrasonography and thermal tomography and molecular subtypes of breast cancer.
      Methods  404 female breast cancer patients with complete imaging data and pathological findings from January 2014 to June 2017 were reviewed in the West China Hospital of Sichuan University. Breast cancer pathological molecules were classified into Luminal A like type, Luminal B like type, human epidermal growth receptor-2 (HER-2) overexpression type and Basal like type according to the expression of various immune markers. The correlation of ultrasonographic BI-RADS signs, thermal tomography characteristics and immunohistochemical results of breast cancer was analyzed.
      Results  Breast cancer lesions with regular morphology, sharp margins, and enhanced posterior echo were more common in Basal like type; Microcalcification was more likely tend to appear in HER-2 expression breast cancer than other subtypes; The q-r curve of Luminal A like breast cancer was nearly 30°, and that was more common between 30°and 45° of HER-2 expression and Basal like breast cancer; The ratio of vertical and horizontal ≥1 of tumors and limited lymph node metastasis could not be used for distinguishing between different subtypes.
      Conclusion  Different molecular subtypes of breast cancer may behave routine ultrasound and thermal tomography imaging features.

     

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