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超声引导下扩散光学断层成像、微血管密度与乳腺癌预后的相关性

Correlations Among Ultrasound-Guided Diffuse Optical Tomography, Microvessel Density, and Breast Cancer Prognosis.

作者信息

Niu Sihua, Zhu Qingli, Jiang Yuxin, Zhu Jiaan, Xiao Mengsu, You Shanshan, Zhou Weixun, Xiao Yu

机构信息

Departments of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

Departments of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

出版信息

J Ultrasound Med. 2018 Apr;37(4):833-842. doi: 10.1002/jum.14416. Epub 2017 Oct 19.

Abstract

OBJECTIVES

To investigate the correlation among ultrasound-guided diffuse optical tomography (DOT), microvessel density, and breast cancer prognosis.

METHODS

Before surgery, the total hemoglobin (Hb) concentrations of 184 female patients with breast cancer with only a single lesion were measured. During follow-up, 23 patients had recurrence or metastatic disease after surgery. Among these patients, 18 with recurrence or metastatic disease within 3 years after surgery were paired with 18 patients without recurrence or metastatic disease. We retrospectively reviewed the pathologic sections of those 36 patients, conducted immunohistochemical staining, and counted the microvessel densities. Then we analyzed the correlation between microvessel density and total Hb, compared total Hb and microvessel density among breast cancers with different prognoses, and tested the value of DOT in predicting the prognosis of breast cancer.

RESULTS

Microvessel density and total Hb were linearly correlated (r = 0.584; P < .001). Total Hb and microvessel density were significantly increased in the metastasis group (P = .001 and .027, respectively). A receiver operating characteristic curve analysis showed that at a total Hb cutoff value of 221.7 μmol/L, the sensitivity, specificity, and area under the curve of DOT for predicting recurrence or metastasis were 0.826, 0.516, and 0.660, respectively.

CONCLUSIONS

The total Hb concentration can reflect a tumor's blood supply. Patients with a high total Hb concentration and microvessel density have a higher risk for a poorer prognosis. Total Hb can be used as an indicator of breast cancer prognosis. Diffuse optical tomography can help physicians identify patients with a high risk of metastasis and make clinical decisions.

摘要

目的

探讨超声引导下扩散光学断层扫描(DOT)、微血管密度与乳腺癌预后之间的相关性。

方法

术前测量184例仅患有单个病灶的女性乳腺癌患者的总血红蛋白(Hb)浓度。随访期间,23例患者术后出现复发或转移性疾病。在这些患者中,将18例术后3年内复发或转移性疾病患者与18例无复发或转移性疾病患者进行配对。我们回顾性分析了这36例患者的病理切片,进行免疫组化染色,并计数微血管密度。然后分析微血管密度与总Hb之间的相关性,比较不同预后乳腺癌患者的总Hb和微血管密度,并检验DOT在预测乳腺癌预后中的价值。

结果

微血管密度与总Hb呈线性相关(r = 0.584;P <.001)。转移组的总Hb和微血管密度显著升高(分别为P = 0.001和0.027)。受试者工作特征曲线分析表明,当总Hb临界值为221.7μmol/L时,DOT预测复发或转移的敏感性、特异性和曲线下面积分别为0.826、0.516和0.660。

结论

总Hb浓度可反映肿瘤的血供情况。总Hb浓度高且微血管密度高的患者预后较差的风险更高。总Hb可作为乳腺癌预后的指标。扩散光学断层扫描可帮助医生识别转移风险高的患者并做出临床决策。

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