Au Frederick Wing-Fai, Ghai Sandeep, Lu Fang-I, Moshonov Hadas, Crystal Pavel
Joint Department of Medical Imaging, Toronto General Hospital, Toronto, Ontario, Canada.
Joint Department of Medical Imaging, Women's College Hospital, Toronto, Ontario, Canada.
J Ultrasound Med. 2017 Sep;36(9):1883-1894. doi: 10.1002/jum.14247. Epub 2017 May 27.
The purpose of this study is to correlate various features of breast cancers on ultrasound to their histological grade and immunohistochemical biomarkers.
Seventy-three patients with 77 invasive breast cancers, diagnosed between August 2011 and December 2014, were included in this prospective analysis. Margin, posterior features, shape, and vascularity were determined from ultrasound and classified according to the Breast Imaging Reporting and Data System lexicon. Histological grade, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status (positive [+] or negative [-]) were determined from surgical pathology reports. The cancers were categorized into low grade (grades 1 or 2) and high grade (grade 3). Correlation of ultrasound features of the cancers to their histological grade and receptor status was performed.
There were 47 low-grade and 29 high-grade cancers. There was a significant difference in margin and posterior features between the low and high grade, ER + and ER-, and PR + and PR- (all P < .05), but not between HER2 + and HER2- cancers (both P > .05). There was no significant difference in shape and vascularity among the different subtypes (all P > .05). Spiculated margin was significantly associated with low-grade, ER+, PR + status; angular margin with high grade; microlobulated margin with ER- status; shadowing with PR + status; and enhancement with high grade, ER- status (all P < .05, all odds ratios ≥ 3.94).
There was significant association of margin and posterior features of breast cancers with their histological grade and receptor status.
本研究旨在将乳腺癌超声检查的各项特征与其组织学分级及免疫组化生物标志物进行关联分析。
本前瞻性分析纳入了2011年8月至2014年12月期间诊断为77例浸润性乳腺癌的73例患者。根据超声确定边缘、后方特征、形态和血管情况，并按照乳腺影像报告和数据系统词典进行分类。根据手术病理报告确定组织学分级、雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（HER2）状态（阳性[+]或阴性[-]）。将癌症分为低级别（1级或2级）和高级别（3级）。对癌症的超声特征与其组织学分级和受体状态进行关联分析。
有47例低级别癌症和29例高级别癌症。低级别与高级别、ER +与ER -、PR +与PR -之间在边缘和后方特征上存在显著差异（均P <.05），但HER2 +与HER2 -癌症之间无显著差异（均P>.05）。不同亚型之间在形态和血管方面无显著差异（均P>.05）。毛刺状边缘与低级别、ER +、PR +状态显著相关；角状边缘与高级别相关；微叶状边缘与ER -状态相关；后方回声衰减与PR +状态相关；增强与高级别、ER -状态相关（均P <.05，所有比值比≥3.94）。
乳腺癌的边缘和后方特征与其组织学分级和受体状态存在显著关联。
