Department of Radiology and Radiological Sciences, Medical University of South Carolina, 169 Ashley Ave, Charleston, SC 29425, USA.
AJR Am J Roentgenol. 2013 Feb;200(2):284-90. doi: 10.2214/AJR.12.8781.
The purpose of this article is to correlate various ultrasound features of breast cancer with tumor grade, and with estrogen, progesterone, and ERRB2 (formerly HER2) receptor status as well as to assess the predictive value of these features.
The features of breast cancers found by using ultrasound between January 2010 and June 2011 were reviewed for tumor size, margins, and posterior acoustic features. The tumor margins were classified into spiculated, angular, indistinct, lobulated or microlobulated, and circumscribed. The posterior acoustic features were classified into shadowing, enhancement, mixed pattern, and no change. The individual features were correlated with the estrogen receptor (ER)-progesterone receptor (PR) and ERRB2 receptor status and tumor grade.
Among 160 patients with breast cancer, 102 (63.8%) were ER-positive/PR-positive, 32 (20.0%) were ER-positive/PR-negative, and 26 (16.3%) were ER-negative/PR-negative (22 were triple-negative). Tumors with posterior shadowing have greater than nine times the odds of having ER-positive findings (95% CI, 2.09-40.81; p = 0.011) and greater than 13 times the odds of having a lower-grade tumor (I or II vs III; 95% CI, 4.90-36.54; p < 0.001) than those without posterior shadowing. Tumors with posterior enhancement have greater than eight times the odds of having at least one negative receptor (95% CI, 3.97-18.11; p < 0.001) and 24 times the odds of having a high-grade tumor (95% CI, 9.91-58.14; p < 0.001) than those without posterior enhancement.
The presence of posterior shadowing is strongly associated with an ER-positive and low-grade tumor, whereas the presence of posterior enhancement is strongly associated with a high-grade tumor and with moderate risk of being receptor negative.
本文旨在探讨乳腺癌的各种超声特征与肿瘤分级、雌激素受体（ER）、孕激素受体（PR）、ERRB2（原 HER2）受体状态的相关性，并评估这些特征的预测价值。
回顾 2010 年 1 月至 2011 年 6 月间通过超声发现的乳腺癌特征，包括肿瘤大小、边界和后方回声特征。肿瘤边界分为有刺状、角状、不清晰、分叶状或微分叶状和边界清晰。后方回声特征分为声影、增强、混合模式和无变化。将各个特征与 ER-PR 和 ERRB2 受体状态及肿瘤分级进行相关性分析。
在 160 例乳腺癌患者中，102 例（63.8%）为 ER-PR 阳性，32 例（20.0%）为 ER-PR 阴性，26 例（16.3%）为 ER-PR 阴性（22 例为三阴性）。有后方声影的肿瘤 ER 阳性发现的几率是无后方声影的 9 倍以上（95%CI，2.09-40.81；p=0.011），且为低级别肿瘤（I 级或 II 级）的几率是无后方声影的 13 倍以上（95%CI，4.90-36.54；p<0.001）。有后方增强的肿瘤至少有一种阴性受体的几率是无后方增强的 8 倍以上（95%CI，3.97-18.11；p<0.001），高级别肿瘤（95%CI，9.91-58.14；p<0.001）的几率是无后方增强的 24 倍以上。
后方声影的存在与 ER 阳性和低级别肿瘤密切相关，而后方增强与高级别肿瘤和中度受体阴性风险密切相关。
