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目的通过研究术前乳腺癌超声光散射断层成像(diffused optical tomography with ultrasonography)的综合诊断指数(synthesis diagnostic index,SDI)以及术后缺氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)、CD105在乳腺癌中的表达,探讨乳腺癌超声光散射断层成像综合诊断指数与缺氧诱导因子-1α表达、微血管密度(microvessel density,MVD)的关系。方法采用超声光散射断层成像系统,研究2008年11月至2010年9月我科131例乳腺良性肿块及142例乳腺癌患者,测量超声光散射断层成像综合诊断指数(synthesis diagnostic index,SDI),通过受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)确定乳腺癌的最佳诊断阈值。使用免疫组化法检测HIF-1α表达与定位,检测乳腺癌MVD。分析超声光散射SDI值与HIF-1α表达、MVD值的关系。分析超声光散射的SDI值以及HIF-1α表达与乳腺癌临床病理特征的关系。结果乳腺良性疾病与乳腺癌的SDI值分别:(109.35±48.03)、(190.87±60.33)。两者之间的差异有统计学意义(P<0.05)。经ROC曲线分析确定,以SDI值>141.2作为乳腺癌的最佳诊断阈值。HIF-1α表达阳性的乳腺癌SDI值高于HIF-1α表达阴性的乳腺癌(P<0.05)。SDI值与MVD值呈正相关(r=0.673,P<0.01)。HIF-1α表达阳性的MVD值大于HIF-1α表达阴性的MVD值(P<0.05)。SDI值、HIF-1α表达与乳腺癌临床病理联系显示:两者与肿瘤大小、淋巴结转移、TNM分期、CerbB-2表达有关(P<0.05)与ER、PR表达无关(P>0.05)。结论超声光散射断层成像系统作为一种新的功能性检测技术对乳腺癌的诊断、病情判断方面有重要的指导意义。
OBJECTIVE: To study the diagnostic index (synthetic diagnostic index, SDI) of diffused optical tomography with ultrasonography and hypoxia inducible factor-1α (HIF-1α) , CD105 expression in breast cancer and explore the relationship between the diagnostic indexes of breast cancer ultrasound light scattering tomography and hypoxia inducible factor-1α expression and microvessel density (MVD). Methods Totally 131 patients with benign breast mass and 142 patients with breast cancer from November 2008 to September 2010 were studied by using ultrasound light scattering tomography system. The diagnostic diagnostic indexes of ultrasound light-scattering tomography (synthetic diagnostic index, SDI) The best diagnostic threshold for breast cancer was determined by receiver operating characteristic curve (ROC curve). Immunohistochemistry was used to detect the expression and localization of HIF-1α, and to detect MVD in breast cancer. The relationship between SDI value and HIF-1α expression and MVD value was analyzed. The relationship between the SDI value of ultrasound light scattering and the expression of HIF-1α and the clinicopathological features of breast cancer was analyzed. Results The values of SDI of breast benign disease and breast cancer were (109.35 ± 48.03) and (190.87 ± 60.33), respectively. The difference between the two groups was statistically significant (P <0.05). ROC curve analysis to determine the SDI value> 141.2 as the best diagnostic threshold for breast cancer. The SDI of HIF-1α-positive breast cancer was higher than that of HIF-1α-negative breast cancer (P <0.05). There was a positive correlation between SDI and MVD (r = 0.673, P <0.01). The MVD of positive HIF-1α expression was greater than that of negative HIF-1α expression (P <0.05). The correlation between SDI, HIF-1α expression and clinicopathological features of breast cancer showed that both of them were correlated with tumor size, lymph node metastasis, TNM staging and CerbB-2 expression (P <0.05) but not ER and PR expression (P> 0.05). Conclusion Ultrasound light scattering tomography system as a new functional detection technology for breast cancer diagnosis, disease judgment has important guiding significance.