乳腺浸润性导管癌的超声特征及其与分子分型的相关性

目的:研究乳腺浸润性导管癌的超声表现特征，分析其与临床病理参数的关系。方法:回顾分析我院2014年1月至2018年12月乳腺外科收治的110例乳腺浸润性导管癌患者临床资料。按照不同分子亚型分为Luminal 型、HER-2 过表达型及TN 型。观察不同亚型乳腺浸润性导管癌患者的超声征象并对比分析。结果:彩色多普勒超声检测显示，乳腺浸润性导管癌病例肿块多呈现为形态不规则、边缘毛刺、垂直生长，以内部回声无变化、无微钙化发生、血流分级2级、淋巴结转移、弹性评分≥3分为主。乳腺浸润性导管癌不同分子分型中超声征象形态、边缘、方位、内部回声、微钙化、血流分级、弹性评分组间差异具有统计学意义（P＜0.05），淋巴结转移与否差异无统计学意义（P＞0.05）。Luminal 型多见于形态不规则、边缘毛刺、垂直生长；TN型多见于形态规则、边缘光整、平行生长；HER-2过表达型多肿块内部微钙化、弹性评分≥3分。不同分子分型组间两两比较，Luminal型和TN型超声征象边缘、方位组间具有统计学差异（P＜0.012 8）；HER-2型和TN型超声征象边缘组间具有统计学差异（P＜0.012 8）；Luminal型和HER-2型超声征象内部回声、微钙化及弹性评分组间具有统计学差异（P＜0.012 8）。结论:乳腺癌超声特征与其分子分型存在一定关系，超声特征可为其分子分型提供一定参考信息。

Relationship between ultrasonic features and molecular typing in invasive ductal carcinoma of breast

Objective:To study the ultrasonographic features of invasive ductal carcinoma of breast and its relationship with clinicopathological parameters.Methods:Clinical data of 110 cases of invasive ductal carcinoma of breast admitted to the breast surgery department of our hospital from January 2014 to December 2018 were retrospectively analyzed.According to different molecular subtypes,they were divided into Luminal type,HER-2 overexpression type and TN type.The ultrasonographic features of different subtypes of invasive ductal carcinoma of breast were observed and compared.Results:Color doppler ultrasonography showed that the masses in invasive ductal carcinoma of breast mostly presented irregular shape,marginal bristles and vertical growth,with no changes in internal echo and no microcalcification,grade 2 blood flow,lymph node metastasis and elasticity score≥3.Among the different molecular types of invasive ductal carcinoma of breast,there were statistically significant differences in ultrasonographic appearance,margin,orientation,internal echo,microcalcification,blood flow grade and elasticity score between groups(P<0.05),but no statistically significant differences in lymph node metastasis(P>0.05).Luminal type was common in irregular shape,edge burr,vertical growth.TN type was mostly found in regular shape,smooth edge and parallel growth.Multiple tumors with HER-2 overexpression had internal microcalcification and elasticity score≥3.Pairwise comparisons of different molecular typing groups showed that there were statistically significant differences between Luminal and TN groups in the edge and orientation of ultrasonic signs(P<0.0128).There was a statistically significant difference between the edge group of HER-2 and TN-type ultrasound signs(P<0.0128).Luminal and HER-2 ultrasonography showed significant differences in internal echo,microcalcification and elasticity between groups(P<0.0128).Conclusion:The ultrasonographic characteristics of breast cancer are related to its molecular typing,and the ultrasonographic characteristics can provide some reference information for its molecular typing.