Liu Yubo, Huang Yini, Han Jing, Wang Jianwei, Li Fei, Zhou Jianhua
Department of Ultrasound, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 6, Guangzhou, China.
J Ultrasound Med. 2019 Jan;38(1):73-80. doi: 10.1002/jum.14663. Epub 2018 Apr 30.
To evaluate the association between shear wave elastography parameters using virtual touch tissue imaging quantification (VTIQ) and the Ki-67 index in luminal-type breast cancer.
Eighty-one patients with 82 lesions of pathologic confirmed luminal-type breast cancer underwent virtual touch tissue imaging quantification examination before surgery between December 2015 and June 2016. Patients were divided into 2 groups according to the Ki-67 index (≥14% versus < 14%), which is used to define luminal type B and luminal type A, respectively. The mean shear wave velocity (SWV ) and lesion-to-adjacent tissues ratio (SWV ratio) were calculated for each lesion.
The SWV , SWV ratio, histologic grade, axillary lymph node involvement, and lymphovascular invasion showed a significant positive association with a high Ki-67 index (all P < .05). Receiver operating characteristic curve analysis for the differential diagnosis between high (≥14%) and low (<14%) Ki-67 groups displayed that the optimal cutoff value for SWV and SWV ratio were 3.99 meters per second and 2.861, with sensitivity 94% and 72%, specificity 40.6% and 56.2%, and area under the receiver operating characteristic curve of 0.689 and 0.651, respectively. Univariate analysis showed that SWV (P = .005), SWV ratio (P = .029), histologic grade (P = .011), presence of axillary node involvement (P = .004), and lymphovascular invasion (P = .008) were significantly associated with high Ki-67 status. Multivariable analysis displayed that SWV (hazard ratio [HR], 1.459, 95% confidence interval [CI], 1.028-2.072; P = .035), histologic grade (HR, 4.105; 95% CI, 1.142-14.763; P = .031), and presence of axillary node involvement (HR, 3.75; 95% CI, 1.228-11.453; P = .020) maintained significance for predicting high Ki-67 status.
The SWV using the virtual touch tissue imaging quantification method showed significant correlation with the Ki-67 index, suggesting the potential to assess tumor proliferation status in luminal-type breast cancer with a noninvasive manner.
评估采用虚拟触诊组织成像定量技术（VTIQ）的剪切波弹性成像参数与腔面型乳腺癌中Ki-67指数之间的关联。
2015年12月至2016年6月期间，81例经病理确诊为腔面型乳腺癌且有82个病灶的患者在手术前行虚拟触诊组织成像定量检查。根据Ki-67指数（≥14%与<14%）将患者分为两组，该指数分别用于定义腔面B型和腔面A型。计算每个病灶的平均剪切波速度（SWV）和病灶与相邻组织比值（SWV比值）。
SWV、SWV比值、组织学分级、腋窝淋巴结受累情况和淋巴管浸润与高Ki-67指数呈显著正相关（均P<0.05）。对高（≥14%）、低（<14%）Ki-67组进行鉴别诊断的受试者工作特征曲线分析显示，SWV和SWV比值的最佳截断值分别为每秒3.99米和2.861，灵敏度分别为94%和72%，特异性分别为40.6%和56.2%，受试者工作特征曲线下面积分别为0.689和0.651。单因素分析显示，SWV（P=0.005）、SWV比值（P=0.029）、组织学分级（P=0.011）、腋窝淋巴结受累情况（P=0.004）和淋巴管浸润（P=0.008）与高Ki-67状态显著相关。多因素分析显示，SWV（风险比[HR]，1.459，95%置信区间[CI]，1.028-2.072；P=0.035）、组织学分级（HR，4.105；95%CI，1.142-14.763；P=0.031）和腋窝淋巴结受累情况（HR，3.75；95%CI，1.228-11.453；P=0.020）在预测高Ki-67状态方面仍具有显著性。
采用虚拟触诊组织成像定量方法的SWV与Ki-67指数呈显著相关，提示有可能以无创方式评估腔面型乳腺癌的肿瘤增殖状态。
