超声特征联合免疫组化对不同组织学分级的乳腺浸润性导管癌的诊断价值

目的:评估乳腺浸润性导管癌（invasive ductal cancer，IDC）的超声特征及免疫组化生物分子的表达在不同组织学分级中的鉴别诊断价值。方法:回顾性分析2017年05月至2019年05月经三家医院收集的390例IDC患者，均接受超声检查及免疫组化检查，并且均经穿刺或手术病理结果证实；分析超声特征及免疫组化生物分子在不同组织学分级IDC之间的差异。结果:不同组织学分级的IDC中，肿瘤方位、回声、微钙化、血流分级表现具有显著统计学差异；ER、HER-2、Ki-67、AR、p53表达水平具有显著统计学差异；根据主成分分析计算得出的综合评分绘制受试者工作特征曲线（receiver operating characteristic curve，ROC），得出IDC I级与Ⅱ、Ⅲ级的AUC、灵敏度、特异度分别是0.611、0.818、0.409，Ⅰ、Ⅱ级与Ⅲ级的AUC、灵敏度、特异度分别是0.596、0.558、0.675。结论:超声特征结合免疫组化生物分子一定程度上可以预测IDC的组织学分级，为临床医师在决策患者的治疗方案中提供一定的指导。

Diagnostic value of ultrasonographic features combined with immunohistochemistry for breast invasive ductal carcinoma with different histological grades

Objective:To evaluate the diagnostic value of differentiating infiltrating ductal carcinoma of breast in different histological grades via analyzing ultrasonographic features and the expression level of immunohistochemical biomolecules.Methods:From May 2017 to May 2019,390 patients with invasive ductal carcinoma of breast from three hospitals were retrospectively collected.All patients were received ultrasound and immunohistochemical examination and were confirmed by biopsy or surgical pathology.Finally,the differences of ultrasonographic features and immunohistochemical biomolecules among different histological grades of invasive ductal carcinoma were compared statistically.Results:Among different histological grades of infiltrating ductal carcinoma,there were significantly statistical differences in the orientation,echo,microcalcification,blood flow grading.The expression levels of ER,HER-2,Ki-67,AR and p53 were statistically significant.ROC curve was drawn according to the comprehensive score calculated by principal component analysis.AUC,sensitivity and specificity of IDC grade Ⅰ and Ⅱ,Ⅲ were 0.611,0.818 and 0.409.AUC,sensitivity and specificity of IDC grade I,Ⅱ and Ⅲ were 0.596,0.558 and 0.675.Conclusion:To a certain extent,both of ultrasound features and immunohistochemical biomolecules can predict invasive ductal carcinoma with different histological grades,which can provide a wise guidance for clinicians in making treatment plans for patients.