Aho Michael, Irshad Abid, Ackerman Susan J, Lewis Madelene, Leddy Rebecca, Pope Thomas L, Campbell Amy S, Cluver Abbie, Wolf Bethany J, Cunningham Joan E
Department of Radiology, Medical University of South Carolina, Charleston, South Carolina 29403, USA.
J Clin Ultrasound. 2013 Jan;41(1):10-7. doi: 10.1002/jcu.21990. Epub 2012 Sep 20.
To determine whether presenting sonographic features of invasive ductal carcinomas (IDC) are associated with patient age, tumor histologic grade, and hormonal receptor status.
Sonographic features of 101 consecutive cases of IDC seen at ultrasound were retrospectively assessed based on the BI-RADS criteria of posterior acoustic appearance, tumor margins, and echogenicity. Associations between sonographic features and tumor characteristics were statistically evaluated with attention to patient age.
IDC with shadowing compared with unchanged posterior acoustic appearance were significantly more likely to be of low histologic grade (Odds Ratio [OR] = 5.00; p < 0.05) and estrogen receptor (ER) -positive (OR = 10.00; p < 0.05). Conversely, posterior enhancement was associated with ER-negative status (OR = 4.45; p < 0.01), particularly among patients younger than 60 years of age (OR = 5.36, p < 0.05). Circumscribed tumors were more often high grade, particularly among older women (p < 0.01), and hormone receptor--negative regardless of age group. Among older women, tumors with mixed echogenicity tended to be high grade and progesterone receptor--negative (p values < 0.05). Noncircumscribed borders were observed for all tumors with posterior shadowing, and 97% of such tumors were also ER positive.
Sonographic features were significantly associated with tumor grade and hormone receptor status, with some differences based on patient age. Specifically, the presence of posterior shadowing was associated with lower histologic grade and ER-positive status, especially in older patients. In contrast, we found that posterior acoustic enhancement was more commonly associated with ER-negative status, especially in younger patients.
确定浸润性导管癌（IDC）的超声表现是否与患者年龄、肿瘤组织学分级及激素受体状态相关。
依据BI-RADS标准，对超声检查发现的101例连续性IDC病例的超声特征进行回顾性评估，评估内容包括后方回声表现、肿瘤边界及回声。在考虑患者年龄的情况下，对超声特征与肿瘤特征之间的关联进行统计学评估。
与后方回声无改变相比，伴有声影的IDC更可能组织学分级低（优势比[OR]=5.00；p<0.05）且雌激素受体（ER）阳性（OR=10.00；p<0.05）。相反，后方增强与ER阴性状态相关（OR=4.45；p<0.01），尤其是在60岁以下患者中（OR=5.36，p<0.05）。边界清晰的肿瘤更常为高级别，尤其是在老年女性中（p<0.01），且无论年龄组均为激素受体阴性。在老年女性中，回声混合的肿瘤往往为高级别且孕激素受体阴性（p值<0.05）。所有伴有后方声影的肿瘤均观察到边界不清，且此类肿瘤的97%也为ER阳性。
超声特征与肿瘤分级及激素受体状态显著相关，且因患者年龄存在一些差异。具体而言，后方声影的存在与较低的组织学分级及ER阳性状态相关，尤其是在老年患者中。相比之下，我们发现后方回声增强更常与ER阴性状态相关，尤其是在年轻患者中。
