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目的应用剪切波弹性成像(shear wave elastography,SWE)定量测定乳腺浸润性导管癌的弹性模量值,并分析其与乳腺浸润性导管癌病理特征、免疫组化因子的相关性及预后特点。方法用常规二维超声检查乳腺实性病灶,选择出BI-RADS分类大于4级以上的病人进行SWE检查,选择病理活检确定为乳腺浸润性导管癌患者(138例),记录其SWE弹性值结果和其病理及免疫组化特征,并分析其与弹性平均值的相关性。结果单因素回归模型分析肿瘤的浸润范围、组织学分级、腋窝淋巴结转移、ER、CK5/6、Ki67的表达与乳腺浸润性导管癌平均值有显著相关性。多元线性回归分析肿瘤的浸润范围、组织学分级、腋窝淋巴结转移、CK5/6、Ki67的表达与乳腺浸润性导管癌平均弹性值具有独立相关性。结论乳腺浸润性导管癌平均弹性值与病理特征及免疫组化指标有明显的相关性,平均弹性值较高的乳腺浸润性导管癌有较差的预后特征。
Objective To quantitatively determine the elastic modulus of infiltrating ductal breast cancer by shear wave elastography (SWE) and analyze the correlation with the pathological features, immunohistochemical characteristics and prognosis of invasive ductal carcinoma of the breast. Methods Two-dimensional ultrasonography was used to detect breast solid lesions. SWE was performed on patients with BI-RADS classification greater than grade 4, and pathological biopsy was selected as invasive ductal carcinoma (138 cases). The results of SWE elasticity And its pathological and immunohistochemical characteristics, and analysis of its correlation with the elastic average. Results The univariate regression analysis showed that the extent of infiltration, histological grade, axillary lymph node metastasis, ER, CK5 / 6 and Ki67 expression were significantly correlated with the mean value of invasive ductal carcinoma in breast. Multivariate linear regression analysis of tumor invasion range, histological grade, axillary lymph node metastasis, CK5 / 6, Ki67 expression with breast invasive ductal carcinoma mean elastic value has an independent correlation. Conclusion The average elastic value of invasive ductal carcinoma of the breast has obvious correlation with the pathological features and immunohistochemical indexes. The infiltrating ductal carcinoma with higher mean elasticity value has poorer prognostic characteristics.