Zheng Feng-Yang, Lu Qing, Huang Bei-Jian, Xia Han-Sheng, Yan Li-Xia, Wang Xi, Yuan Wei, Wang Wen-Ping
Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai 200032, China.
Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Eur J Radiol. 2017 Jan;86:267-275. doi: 10.1016/j.ejrad.2016.11.032. Epub 2016 Nov 28.
To investigate the correlation between the imaging features obtained by an automated breast volume scanner (ABVS) and molecular subtypes of breast cancer.
We examined 303 malignant breast tumours by ABVS for specific imaging features and by immunohistochemical analysis to determine the molecular subtype. ABVS imaging features, including retraction phenomenon, shape, margins, echogenicity, post-acoustic features, echogenic halo, and calcifications were analysed by univariate and multivariate logistic regression analyses to determine the significant predictive factors of the molecular subtypes.
By univariate logistic regression analysis, the predictive factors of the Luminal-A subtype (n=128) were retraction phenomenon (odds ratio [OR]=10.188), post-acoustic shadowing (OR=5.112), and echogenic halo (OR=3.263, P<0.001). The predictive factors of the Human-epidermal-growth-factor-receptor-2-amplified subtype (n=39) were calcifications (OR=6.210), absence of retraction phenomenon (OR=4.375), non-mass lesions (OR=4.286, P<0.001), absence of echogenic halo (OR=3.851, P=0.035), and post-acoustic enhancement (OR=3.641, P=0.008). The predictors for the Triple-Negative subtype (n=47) were absence of retraction phenomenon (OR=5.884), post-acoustic enhancement (OR=5.255, P<0.001), absence of echogenic halo (OR=4.138, P=0.002), and absence of calcifications (OR=3.363, P=0.001). Predictors for the Luminal-B subtype (n=89) had a relatively lower association (OR≤2.328). By multivariate logistic regression analysis, retraction phenomenon was the strongest independent predictor for the Luminal-A subtype (OR=9.063, P<0.001) when present and for the Triple-Negative subtype (OR=4.875, P<0.001) when absent.
ABVS imaging features, especially retraction phenomenon, have a strong correlation with the molecular subtypes, expanding the scope of ultrasound in identifying breast cancer subtypes with confidence.
研究自动乳腺容积扫描仪（ABVS）获得的成像特征与乳腺癌分子亚型之间的相关性。
我们通过ABVS检查了303例乳腺恶性肿瘤的特定成像特征，并通过免疫组化分析确定分子亚型。通过单因素和多因素逻辑回归分析对ABVS成像特征，包括回缩现象、形态、边界、回声性、后方回声特征、回声晕和钙化进行分析，以确定分子亚型的显著预测因素。
通过单因素逻辑回归分析，Luminal-A亚型（n = 128）的预测因素为回缩现象（比值比[OR]=10.188）、后方声影（OR = 5.112）和回声晕（OR = 3.263，P<0.001）。人表皮生长因子受体2扩增亚型（n = 39）的预测因素为钙化（OR = 6.210）、无回缩现象（OR = 4.375）、非肿块性病变（OR = 4.286，P<0.001）、无回声晕（OR = 3.851，P = 0.035）和后方回声增强（OR = 3.641，P = 0.008）。三阴性亚型（n = 47）的预测因素为无回缩现象（OR = 5.884）、后方回声增强（OR = 5.255，P<0.001）、无回声晕（OR = 4.138，P = 0.002）和无钙化（OR = 3.363，P = 0.001）。Luminal-B亚型（n = 89）的预测因素相关性相对较低（OR≤2.328）。通过多因素逻辑回归分析，回缩现象是Luminal-A亚型存在时最强的独立预测因素（OR = 9.063，P<0.001），也是三阴性亚型不存在时最强的独立预测因素（OR = 4.875，P<0.001）。
ABVS成像特征，尤其是回缩现象，与分子亚型有很强的相关性，扩大了超声在自信识别乳腺癌亚型方面的应用范围。
