乳腺癌超声征象与肿瘤干细胞及上皮间质转化标志物表达水平的相关性

目的探讨乳腺癌超声征象与肿瘤干细胞及上皮间质转化标志物表达水平的相关性及其意义。方法选择在我院行乳腺癌手术的患者组织标本98例，分析每位患者对应的乳腺超声征象，包括肿块周边是否有毛刺、边缘是否有高回声晕、纵横比、后方回声情况、微小钙化、内部血流显像分级；并采用免疫组化方法检测组织样本中CD24、CD44、E-cadherin、N-cadherin、β-catenin、Vimentin的表达情况，分析其与超声表现的相关性。分析其它可能影响肿瘤干细胞及上皮间质转化标志物表达的因素；对肿瘤干细胞及上皮间质转化标志物表达相关性进行多因素logistic回归分析。结果肿瘤周边是否有毛刺与CD44、E-cadherin、N-cadherin、β-catenin的表达水平差异有统计学意义（P < 0.05）。肿块边缘是否有高回声晕与CD44和E-cadherin的表达水平差异有统计学意义（P < 0.05）。肿块纵横比、后方回声变化均与E-cadherin的表达水平差异有统计学意义（P < 0.05）。血流分级、腺体类型与CD44的表达水平差异有统计学意义（P < 0.05）。腺体背景类型是CD24表达的独立相关因素（P < 0.05）。血流情况、雌孕激素受体表达情况是CD44表达的独立相关因素（P < 0.05）。有无高回声晕、肿块后方回声特征、腋窝淋巴结是否有转移是E-cadherin表达的独立相关因素（P < 0.05）。临床分期是N-cadherin表达的独立相关因素（P < 0.05）。边缘有无毛刺是β- catenin表达的独立相关因素（P < 0.05）。结论乳腺癌超声征象与肿瘤干细胞及上皮间质转化标志物表达之间存在联系，超声征象可作为无创性预测乳腺癌患者肿瘤干细胞及上皮间质转化标志物表达水平的方式，并可为预测乳腺癌潜在的侵袭能力提供更多依据。 

Correlation between ultrasonographic features and expression of tumor stem cells and epithelial mesenchymal transition markers in breast cancer

ObjectiveTo investigate the correlation and significance of ultrasonographic signs of breast cancer with the expression level of tumor stem cells and epithelial mesenchymal transformation markers.MethodsA total of 98 tissue specimens from patients undergoing breast cancer surgery in our hospital were selected. The corresponding breast ultrasound signs of each patient were analyzed, including whether there were burrs around the mass, whether there was hyperechoic halo at the edge, aspect ratio, posterior echo, microcalcification, and internal blood flow imaging grade. The expression of CD24, CD44, E-cadherin, N-cadherin, β-catenin, Vimentin were detected by immunohistochemistry. The correlation between these indexes and ultrasound findings were analyzed. Other factors that may affect the expression of tumor stem cells and epithelial mesenchymal transition markers were analyzed. Multivariate logistic regression analysis was used to analyze the correlation between the expression of tumor stem cells and epithelial mesenchymal transition markers.ResultsThe presence of burr around the tumor was significantly different with the expression levels of CD44, E-cadherin, N-cadherin and β-catenin (P < 0.05). The expression level of CD44 and E-cadherin were significantly different with the presence of hyperechoic halos at the edge of the mass (P < 0.05).The changes of aspect ratio and posterior echo of the tumor were significantly different with the expression level of E-cadherin (P < 0.05).There were significant differences in blood flow grade, gland type and CD44 expression level (P < 0.05). Gland background type was an independent factor associated with CD24 expression. Blood flow and grouping according to estrogen receptor expression were independent correlative factors of CD44 expression. The presence of hyperechoic halos, posterior echo characteristics of the mass, and axillary lymph node metastasis were independent related factors of E-cadherin expression. Clinical staging was an independent factor associated with N-cadherin expression. The presence of burr on the edge was an independent factor related to β-catenin expression.ConclusionUltrasound signs of breast cancer are associated with the expression of tumor stem cells and epithelial mesenchymal transformation markers. Ultrasound signs can be used as a way to noninvasively predict the expression level of tumor stem cells and epithelial mesenchymal transformation markers in breast cancer patients, and can provide more evidence for predicting the potential invasion ability of breast cancer.