乳腺癌对比增强能谱乳腺 X 线摄影与免疫组化标记物的相关性研究.

Correlation between contrast-enhanced spectral mammography and immunohistochemical markers in breast cancer.

Objective To study the difference between the positive and negative immunohistochemical markers in the morphological features of contrast-enhanced spectral mammography (CESM), and analyze its clinical significance. Methods 88 patients with pathologically confirmed breast cancer underwent CESM and immunohistochemical marker detection including estrogen receptor (ER), progesterone receptor (PR), human epidermis growth factor receptor-2 (HER-2) and cell proliferation antigen markers (Ki-67). The morphological features of lesions on CESM including the size, margin, morphology, microcalcification, and degree of contrast enhancement were retrospectively analyzed. Correlation analysis with immunohistochemical markers was performed. Results The 88 lesions were invasive carcinoma (64), intraductal carcinoma-in-situ (10), invasive carcinoma with intraductal carcinoma-in-situ (10), invasive carcinoma with papillary carcinoma (2), and intraductal carcinoma with papillary carcinoma (2) . The positive rates of immunohistochemical markers were 61.36% ER+, 50.00% PR+, 70.45% HER-2+, and 84.09% Ki-67+. There was significant correlation between tumor size and Ki-67positive expression (P=0.003) ; morphology and PR (P=0.031) and HER-2 (P=0.001) positive expressions; microcalcification and Ki-67positive expression (P=0.009) ; “burr sign” and ER positive expression (P=0.020) ; the degree of enhancement and HER-2 (P=0.014) and Ki-67 (P=0.030) positive expression. Conclusion Morphological characteristics of CESM correlate with immunohistochemical markers and are valuable in the diagnosis, treatment and prognosis assessment of breast cancer. [ABSTRACT FROM AUTHOR]

目的 研究对比增强能谱乳腺X线摄影 (CESM) 形态学特征在免疫组化标记物阳性与阴性之间的差异性,分析其临床意义｡ 方法 回顾性分析病理诊断乳腺癌患者88例,均行 CESM 检查及免疫组化标记物检测[雌激素受体(ER)、孕激素受体 (PR)、人类表皮生长因子受体-2 (HER-2) 及细胞增殖抗原标记物 (Ki-67)], 分析乳腺癌患者 CESM 病灶形态学特征大小、边缘、形态、微钙化、强化程度,将 CESM 形态学特征与免疫组化标记物进行相关性分析｡ 结果 88 例乳腺癌患者中浸润性癌 64 例,导管内原位癌10 例,浸润性癌伴导管内原位癌 10 例, 浸润性癌伴乳头状癌 2例,导管内癌伴乳头状癌 2 例｡ 免疫组化标记物 ER、PR、HER-2、Ki-67 在乳腺癌患者中阳性率分别为 61.36％、50.00％、70.45％、84.09％｡ 肿瘤大小与 Ki-67 阳性表达有关(P=0.003);形态与PR、HER-2阳性表达有关(P=0.031、0.001); 微钙化与 Ki-67 阳性表达有关(P=0.009); "毛刺征" 与 ER 阳性表达有关 (P=0.020); 强化程度与HER-2、Ki-67阳性表达有关 (P=0.014、0.030)｡ 结论 乳腺癌CESM形态学特征与免疫组化标记物之间存在一定的相关性｡ CESM 形态学特征在乳腺癌诊治及预后评估方面具有较大的参考价值｡ [ABSTRACT FROM AUTHOR]