乳腺肿瘤超声弹性成像与肌成纤维细胞分布的相关性及临床意义

目的探讨乳腺肿瘤超声弹性成像和肌成纤维细胞分布之间的相关性以及临床诊断意义。方法选取浙江省青田县人民医院2010年1月～2011年6月治疗的乳腺肿块患者200例。乳腺良性病变98例为良性组,乳腺癌病变102例为恶性组。并采取免疫组织化学法测定两组乳腺间质i型跨膜糖蛋白（CD34）和α平滑肌肌动蛋白（α-SMA）表达,并分析肌成纤维细胞在患者病灶的分布情况,采取超声弹性成像技术进行评估弹性成像和肌成纤维细胞分布的相关性。结果恶性组弹性成像中观察肿块均显示为蓝色,评分为（7.0±0.3）分,良性组弹性成像中观察肿块大部分显示为绿色,肿块内部显示极少的蓝色,评分为（2.2±0.4）分;良性组中CD34蛋白主要定位于细胞质中,α-SMA蛋白主要定位于导管肌的上皮细胞中;恶性组中CD34蛋白主要定位于血管中,α-SMA蛋白主要定位于细胞质中。恶性组CD34表达水平明显低于良性组,而α-SMA表达水平明显高于良性组,两组比较差异有统计学有意义（P〈0.05）。CD34的表达和弹性成像呈现负相关性（r=-0.124,P〈0.05）;α-SMA的表达和弹性成像呈现正相关性（r=0.132,P〈0.05）。结论临床中采取超声弹性成像能够有效的判断肌成纤维细胞在乳腺肿瘤的分布情况,在临床中诊断乳腺肿瘤具有一定的意义。

Pertinence and clinical significance of ultrasound elastography and myofibroblasts distribution in breast cancer

Objective To investigate the pertinence and clinical diagnostic significance of ultrasound elastography and myofibroblasts distribution in breast cancer.Methods 200 patients with breast mass admitted to People＇s Hospital of Qingtian County from January 2010 to June 2011 were selected and assigned into malignant group with 98 cases and benign group with 102 cases.The expression of i-type transmembrane glycoprotein（CD34） and α-smooth muscle actin（α-SMA） in breast mesenchyme were determined by immunohistochemical method in two groups.The distribution of myofibroblasts in nidus of patients were analyzed,and the pertinence of elastography and distribution of myofibrob last were also evaluated by ultrasound elastography technology.Results The masses observed in malignant group by elastography were shown in blue with（7.0±0.3） scores,while most of the masses in benign group were shown in green and minimal blue within the masses with（2.2±0.4） scores.The CD34 protein and α-SMA were mainly localized in cytoplasm and epithelial cells of catheter muscle respectively in benign group,while in blood vessels and cytoplasm re spectively in malignant group.The expression levels of CD34 in malignant group were significantly lower than these in benign group,while the expression levels of α-SMA were significantly higher than these in benign group,the differ ences were statistically significant（P 0.05）.The compared difference of two sets of data was statistically significant（P 0.05）.There was negative correlation between CD34 expression and elastography（r =-0.124,P 0.05）,while positive correlation was found between α-SMA and elastography（r = 0.132,P 0.05）.Conclusion Clinically applying of ultrasound elastography can effectively determine the distribution of myofibroblasts in breast tumor,it has certain significance in clinical diagnosis.