524例乳腺浸润性导管癌的超声征象与多种免疫组化因子表达的相关性

  目的  探索乳腺浸润性导管癌超声征象与多种免疫组化因子表达的相关性。  方法  回顾性分析我院2019年1月~2021年12月经手术病理证实为乳腺原发性浸润性导管癌患者524例，术前进行超声检查并留存有标准的超声声像图，采用单因素分析χ2检验和二元Logistic回归分析超声声像图征象与雌激素受体（ER）、孕激素受体（PR）、人类表皮因子受体2（HER-2）、P53、细胞核增殖因子Ki-67、DNA拓扑异构酶IIa（TOPIIa）、细胞角蛋白CK5/6免疫组化因子表达的相关性，并构建Logistic回归方程。  结果  Logistic回归分析发现ER的阳性表达与肿块形状、肿块边缘、后方回声、高回声晕、血供丰富之间存在相关性（P < 0.05）；PR的阳性表达与肿块边缘、高回声晕、直径 > 2 cm存在相关性；HER-2的阳性表达与内部微钙化、纵横比 > 1之间存在相关性（P < 0.05）；Ki-67的高表达与淋巴结转移、后方回声减低之间存在相关性（P < 0.05）；P53的阳性表达与内部钙化、淋巴结转移、肿块形状、高回声晕之间存在相关性（P < 0.05）；CK5/6的阳性表达与内部微钙化和高回声晕之间存在相关性（P < 0.05）；TOPIIa的阳性表达与淋巴结转移、后方回声、肿块直径 > 2 cm存在相关性（P < 0.05），得出相应的回归方程并以ROC曲线检验方程效能。  结论  不同免疫组化表达的浸润性导管癌的征象具有一定的差异，这些超声征象可为乳腺癌的诊断、临床治疗和预后评估提供重要参考依据。 

Logistic regression analysis of correlation between ultrasonic signs and expression of multiple immunohistochemical factors in 524 cases of invasive ductal carcinoma of breast

  Objective  To explore the correlation between ultrasonographic signs of invasive ductal carcinoma of breast and the expression of immunohistochemical factors.  Methods  We retrospectively analyzed 524 patients with primary invasive ductal carcinoma of breast confirmed by surgical pathology in our hospital from January 2019 to December 2021. Preoperative ultrasound examination was performed and standard ultrasound images were retained. Univariate analysis χ2 test and binary logistic regression were used to analyze the correlation between ultrasonographic signs and the expression of ER, PR, HER-2, P53, Ki-67, TOPIIa and CK5/6 immunohistochemical factors. The logistic regression equation was established.  Results  Logistic regression analysis showed that positive expression of ER was correlated with tumor shape, tumor margin, posterior echo, hyperecho halo and abundant blood supply (P < 0.05). The positive expression of PR was associated with tumor margin, hyperechoic halo, diameter > 2 cm. Positive HER-2 expression and internal microcalcification, aspect ratio diameter greater than 1 (P < 0.05). The high expression of Ki-67 was correlated with lymph node metastasis and posteriorechogenicity (P < 0.05). The positive expression of P53 was correlated with internal calcification, lymph node metastasis, tumor shape and hyperechoic halo (P < 0.05). The positive expression of CK5/6 was correlated with internal microcalcification and hyperechoic halo (P < 0.05). The positive expression of TOPIIa was associated with lymph node metastasis, posterior echo, and tumor diameter > 2 cm (P < 0.05). The corresponding regression equation was obtained and ROC curve was used to test the efficiency of the equation.  Conclusion  There are some differences in the signs of invasive ductal carcinoma with different immunohistochemical expressions. These ultrasound signs can provide important reference for the diagnosis, clinical treatment and prognosis assessment of breast cancer, and further link imaging and pathology together.