乳腺癌剪切波弹性成像与其分子亚型和组织病理学特征的相关性分析
Correlation of shear wave elastography with molecular subtype and histopathological features in breast carcinoma

摘要：目的 探讨乳腺癌剪切波弹性成像(SWE)定量特征与其分子亚型和组织病理学特征的相关性。方法 选择经手术病理证实的106例乳腺癌患者的107个病灶，术前均行常规超声和SWE检查，记录其弹性模量最大值(E max)、弹性比值比(E ratio)； 术后记录其临床病理及分子亚型Luminal A型、Luminal B型、Erb-B2过表达型和Basal-like型等免疫组化特征，并分析其与E max和E ratio的相关性。结果 4种亚型在肿块大小、病理分级、BI-RADS分类、E max及E ratio方面差异均有统计学意义(P<0.05)；各亚型中，Erb-B2过表达型的硬度最大，Luminal样型次之，Basal-like型最小，差异有统计学意义(P<0.05)；各病理类型的乳腺癌病灶硬度不同，其中黏液癌硬度最大，导管癌和髓样癌次之，小叶癌最软；随着肿块大小的增加E max及E ratio递增，存在线性关系；病灶病理分级和BI-RADS分类越高，E max及E ratio越大，差异有统计学意义(P<0.05)。结论 乳腺癌硬度与其分子亚型和组织病理学特征存在一定相关性，剪切波弹性成像对病变硬度的评估可为乳腺癌内分泌治疗和预后评估提供重要的参考价值。
ABSTRACT: Objective To explore the correlation of quantitative features of shear wave elastography (SWE) of breast cancer with its molecular subtypes and histopathological features. Methods The 107 lesions of 106 cases of breast cancer confirmed by pathology were examined by conventional ultrasonography and SWE before surgery. The maximum elasticity values (E Max) and elasticity ratio (E ratio) were recorded. We also recorded the immunohistochemical features including clinical pathological features and molecular subtypes (Luminal A, Luminal B, Erb-B2 overexpression and Basal-like), and analyzed its correlation with E Max and E ratio. Results There were significant differences in mass size, pathological grade, BI-RADS classification, E Max and E ratio between the 4 subtypes (P<0.05). As for hardness among the 4 subtypes, the largest one was Erb-B2 overexpression, followed by Luminal-like and the smallest was Basal-like, with statistically significant differences among the subgroups (P<？？0.05？？). The stiffness of various pathological types of breast cancer was disparate, among which mucous carcinoma was the hardest, followed by ductal carcinoma and medullary carcinoma, and lobular carcinoma was the softest. The E Max and E ratio increased with the increase of mass size with linear correlation. The higher the pathological grade and BI-RADS classification of the lesion, the greater value of E Max and E ratio, with significant differences (P<0.05). Conclusion There is a certain degree of correlation between the stiffness of breast cancer and its molecular subtypes and histopathological features. The evaluation of lesions by SWE can provide important reference for endocrine therapy and prognosis evaluation of breast cancer