乳腺癌超声特征与免疫组化指标的相关性

目的探讨乳腺癌超声特征与免疫组化指标的相关性。方法回顾性收集710例经病理证实的乳腺癌肿块资料，记录肿块的超声特征:肿块最大径、位置、纵横比、内部回声、后方回声、边界、边缘、形状、钙化、Alder血流分级、淋巴结转移分析免疫组化指标:雌激素受体（ER）、孕激素受体（PR）、增殖细胞核抗原（Ki-67）、人表皮生长因子受体（HER-2），分析超声特征与免疫组化指标之间的相关性。结果710例乳腺癌肿块中ER、PR、HER-2、Ki-67的阳性率分别为72.5%、64.1%、61.0%、80.3%，且ER与PR表达呈正相关（r=0.697，P < 0.001），ER、PR与Ki-67表达均呈负相关（r=-0.218，P < 0.001；r=-0.216，P < 0.001）。ER、PR在肿块最大径≤2 cm中的阳性率更高，Ki-67在肿块最大径 > 2 cm中的阳性率更高。ER阳性时，肿块纵横比 > 1占比较高，PR阳性时，乳腺癌肿块的超声特征多表现为形状不规则、边界不清晰、后方回声衰减或消失。HER-2、Ki-67阳性时肿块纵横比≤1多见且更容易发生腋窝淋巴结转移。结论乳腺癌的超声特征与ER、PR、HER-2、Ki-67表达存在相关性，超声表现可以反映肿块的生物学行为，为患者的临床治疗方案选择及术后预后评估提供有力的参考依据。 

Correlation between ultrasound features and immunohistochemical markers in 710 cases of breast cancer

ObjectiveTo investigate the correlation between the ultrasonic features and immunohistochemical parameters in breast cancer.MethodsThe data of 710 cases of breast cancer proved by pathology were collected retrospectively. The sonographic features (the maximum diameter, position, aspect ratio, internal echo, posterior echo, boundary, margin, shape, calcification, Alder blood flow grading, lymph node metastasis) and immunohistochemical parameters (ER, PR, HER-2, Ki-67) were recorded. The correlation between ultrasonic features and immunohistochemical parameters was analyzed.ResultsThe positive rates of ER, PR, HER-2 and Ki-67 were 72.5%, 64.1%, 61.0% and 80.3% in 710 breast cancer masses, respectively. The positive rate of ER and PR was higher in the maximum diameter ≤2 cm, and that of Ki-67 was higher in the maximum diameter > 2 cm. When ER was positive, the ratio of breast cancer was more than 1(P < 0.001). When PR was positive, the ultrasonic features of breast cancer were irregular shape, unclear boundary, attenuation or disappearance of Posterior Echo. When HER-2 and Ki-67 were positive, the ratio of vertical to horizontal was≤1(P < 0.001), and the axillary lymph node metastasis was more likely.ConclusionThe ultrasonic features of breast cancer are correlated with the expressions of ER, PR, HER-2 and Ki-67, which can reflect the biological behavior of the tumor. It provides a powerful reference for the choice of clinical treatment plan and the evaluation of postoperative prognosis.