超声联合钼靶诊断乳腺浸润性导管癌及超声征象与P53表达的相关性

目的 研究高频彩色多普勒超声与钼靶X线联合诊断乳腺浸润性导管癌的价值,并探讨超声征象与P53基因表达的相关性.方法 选取79例均经术后病理证实为乳腺浸润性导管癌,分析彩色多普勒声像图特征和钼靶X线结果,比较两者诊断乳腺浸润性导管癌的准确率,并将这些病理标本经免疫组织化学染色检测P53基因表达情况,并研究其与超声征象之间的相关性.结果 79例乳腺癌的患者中,超声诊断准确率为89.87% （71/79）,钼靶X线诊断的准确率为73.42%（58/79）,两者联合诊断的准确率为92.41%（73/79）.超声征象中肿块后方伴有回声衰减者和肿块内血流信号较丰富者（血流信号Ⅱ~Ⅲ级）P53基因阳性发生率高,差异有统计学意义（P〈0.05）.伴有腋窝淋巴结肿大者P53基因阳性者较未发生淋巴结转移者高,两者差异有统计学意义（P〈0.05）.结论 钼靶X线联合高频彩色多普勒超声可以提高乳腺浸润性导管癌的准确率,高频超声彩色多普勒表现征象与P53基因表达具有相关性,且对于预测肿瘤的良恶性及临床预后具有一定的指导意义.

Combination of high frequency ultrasonography and mammography in diagnosis of breast infiltrative ductal carcinoma and correlation between ultrasound findings and expression of P53 in the patients

Objective To explore the value of high frequency ultrasound and mammography in the diagnosis of breast infiltrative ductal carcinoma, and at the same time, to evaluate the correlation between ultrasound findings and the expression of P53 in the patients. Methods A total of 79 patients with invasive breast ductal carcinoma by histopathology test from January 2010 to September 2013 were recruited in this study, their sonograms and mammographic resuhs were analyzed, and the accurate rate of diagnosis was compared. Mean-while, the correlation between ultrasound findings and the expression of P53 was evaluated in the patients. Results There were 71 cases of breast cancer diagnosed by preoperative uhrasonography in 79 patients with invasive mammographic breast ductal carcinoma by histopathology test （71/79）, and the accuracy was 89.87% ; while there were 58 cases of breast cancers diagnosed by mammography （58/79） , and the ac-curacy was 73.42%. The combination of two methods increased the diagnosis accurate rate to 92.41%. Significant correlation was found between back echoes attenuation as well as grading II -III blood flow and the expression of P53 （ P 〈 0.05 ）. Axillary lymph node enlargement also had significant correlation with the expression of P53 （ P 〈 0.05 ）. Conclusion The combination of high frequency ultrasonography and mammography can increase the diagnosis accuracy of breast infiltrative ductal carcinoma. The correlation between ultrasound findings and the expression of P53 in the patients can predict the benign or malignant of tmnors and may have some guiding significance in the clinical prognosis.