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三维超声测量乳腺癌肿瘤体积倍增时间的相关因素分析

Correlation Factors Analysis of Breast Cancer Tumor Volume Doubling Time Measured by 3D-Ultrasound.

作者信息

Zhang Shuyin, Ding Yan, Zhou Qiaoying, Wang Cheng, Wu Pengxi, Dong Ji

机构信息

Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland).

Department of Medical Ultrasound, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, Jiangsu, China (mainland).

出版信息

Med Sci Monit. 2017 Jun 27;23:3147-3153. doi: 10.12659/msm.901566.

Abstract

BACKGROUND Tumor volume doubling time (TVDT) is relatively important for breast cancer diagnosis and prognosis evaluation. This study aimed to analyze the related factors that may affect the TVDT of breast cancer by three-dimensional ultrasound (3D-US). MATERIAL AND METHODS A total of 69 breast cancer patients were selected. 3D-US was applied to measure the volume of breast lumps diagnosed as BI-RADS-US 4A by conventional ultrasound. TVDT was calculated according to the formula TVDT=DT×log2/log(V2/V1). Multiple linear regression analysis was performed to analyze the factors influencing breast cancer TVDT. RESULTS The mean and median TVDT were 185±126 (range 66-521) and 164 days, respectively. TVDT showed no statistical significance according to regular shape, coarse margin, spicule sign, peripheral hyperechoic halo, microcalcification, and different posterior echo characteristics (P>0.05). Patients grouped by age, axillary lymphatic metastasis, histological differentiation, and Nottingham prognostic index (NPI) score exhibited significantly different TVDT (P<0.05). On the contrary, patients with different menstrual conditions, breast cancer family history, or pathological types presented similar TVDT (P>0.05). TVDT was obviously different in breast cancer with different ER, PR, Ki-67, and molecular subtyping but not HER2 expression. Multivariate analysis revealed that NPI score, axillary lymphatic metastasis, Ki-67, and molecular subtyping were risk factors of TVDT in breast cancer (P<0.05). CONCLUSIONS Breast cancer TVDT was significantly correlated with NPI score, axillary lymphatic metastasis, Ki-67, and molecular subtyping. Triple-negative breast cancer exhibited the most rapid growth.

摘要

背景 肿瘤体积倍增时间(TVDT)对乳腺癌的诊断和预后评估较为重要。本研究旨在通过三维超声(3D-US)分析可能影响乳腺癌TVDT的相关因素。

材料与方法 共选取69例乳腺癌患者。应用3D-US测量经传统超声诊断为BI-RADS-US 4A的乳腺肿块体积。根据公式TVDT = DT×log2/log(V2/V1)计算TVDT。进行多元线性回归分析以分析影响乳腺癌TVDT的因素。

结果 TVDT的均值和中位数分别为185±126(范围66 - 521)天和164天。根据规则形状、边缘粗糙、毛刺征、周边高回声晕、微钙化以及不同的后方回声特征,TVDT无统计学意义(P>0.05)。按年龄、腋窝淋巴结转移、组织学分化和诺丁汉预后指数(NPI)评分分组的患者TVDT有显著差异(P<0.05)。相反,不同月经状况、乳腺癌家族史或病理类型的患者TVDT相似(P>0.05)。不同雌激素受体(ER)、孕激素受体(PR)、Ki-67和分子亚型的乳腺癌TVDT明显不同,但与人类表皮生长因子受体2(HER2)表达无关。多因素分析显示NPI评分、腋窝淋巴结转移、Ki-67和分子亚型是乳腺癌TVDT的危险因素(P<0.05)。

结论 乳腺癌TVDT与NPI评分、腋窝淋巴结转移、Ki-67和分子亚型显著相关。三阴性乳腺癌生长最为迅速。

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