4 种分子分型乳腺癌的超声特征分析

目的 分析4种分子分型乳腺癌的超声特征。方法 选取2014年1月—2020年4月芜湖市中医医院 接受乳腺彩超检查并经手术后病理确诊的乳腺癌女性患者66例，依据免疫组织化学结果，将乳腺癌分为Luminal A 型（13例）、Luminal B型（29例）、HER-2过表达型（11例）、三阴性（13例）4种分子分型，分析总结4种分子分型 乳腺癌的大小、淋巴结是否转移、病理分级情况及超声征象，包括形态、边缘毛刺、纵横比、微钙化、后方回声 衰减、血供情况。结果 4种分子分型乳腺癌的肿瘤大小和病理分级构成比的比较，差异无统计学意义（P > 0.05）；淋巴结转移构成比的比较，差异有统计学意义（P <0.05）。4种分子分型乳腺癌超声征象构成比的比较，差 异有统计学意义（P <0.05）；进一步两两比较，三阴性乳腺癌与Luminal A型在形态方面比较，与Luminal B型在形 态、纵横比、后方回声衰减方面比较，与HER-2 过表达型在微钙化方面比较，差异均有统计学意义（P < 0.008）；Luminal B型与HER-2过表达型在微钙化方面比较，差异有统计学意义（P <0.008）。结论 4种分子分 型的乳腺癌具有一定的超声征象，且有一定的差异性，临床医师可借助超声征象来对乳腺癌的分子分型进行预 测，为临床诊断及治疗方案的选择提供更多的参考依据。

Ultrasonographic features of four molecular subtypes breast cancer

Objective To investigate the ultrasonographic features of four molecular subtypes of breast cancer. Method From January 2014 to April 2020, 66 cases of breast cancer were diagnosed by color Doppler ultrasound and confirmed by surgery and pathology in our hospital. According to immunohistochemical results, breast cancer were divided into four molecular subtypes, i.e. Luminal A type (n = 13), Luminal B type (n = 29), HER- 2 over-expression type (n = 11), and triple-negative breast cancer (n = 13). The ultrasonographic features of four molecular subtypes of breast cancer were retrospectively analyzed, including the shape, spiculated margin, D/W ratio, fine calcification, posterior echo attenuation, blood flow, tumor sizes, lymph node metastasis, and histopathological grade. Results There was no statistically significant difference in the tumor sizes and histopathological grade among them (both P > 0.05); in the lymph node metastasis, there was a statistically significant difference (P < 0.05); ultrasonographic features (shape, spiculated margin, D/W ratio, fine calcification, posterior echo attenuation, blood flow) had statistically significant difference among four subtypes (all P < 0.05). Triple-negative breast cancer were statistically significant difference from those of Luminal A type (shape), Luminal B type (shape, D/W ratio, posterior echo attenuation), HER-2 over-expression type (fine calcification) (all P < 0.008). There was a significant difference between Luminal B and HER-2 over-expression type in fine calcification (P < 0.008). Conclusion Four molecular subtypes of breast cancer have certain ultrasonographic features. Clinicians can predict the four molecular subtypes of breast cancer according to the ultrasonographic features, which could provide more basises for the clinical treatment and diagnosis.