the Department of Ultrasound, Affiliated Provincial Hospital of Anhui Medical University, First Affiliated Hospital of the University of Science and Technology of China, Anhui Provincial Hospital, Hefei, China.
Department of Ultrasound, Children's Hospital of Anhui Province, Hefei, China.
J Ultrasound Med. 2019 Jul;38(7):1833-1840. doi: 10.1002/jum.14879. Epub 2018 Nov 27.
To explore the association between the ultrasound (US) characteristics of breast tumors with axillary lymph node metastasis (ALNM) and Ki-67 expression in patients with breast cancer.
In total, 527 consecutive patients with breast cancer who had undergone US examinations and curative surgery with axillary lymph node evaluations were included. The size, shape, aspect ratio, margin, internal echo, internal calcification, posterior echo attenuation, lymphatic hilar structure, cortical thickness, and blood flow of the axillary lymph nodes or primary breast lesions were observed with conventional US. Pathologic prognostic factors, including the histologic type of the tumor, histologic grade, estrogen and progesterone receptor status, lymph node status, and Ki-67 expression were determined. A logistic regression model was used to evaluate whether the US characteristics of primary breast lesions were associated with ALNM and Ki-67 expression.
The maximum tumor diameter (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.05-2.27; P = .028), tumor margin (OR, 2.89; 95% CI, 1.69-4.94; P < .001), internal echo (OR, 2.17; 95% CI, 1.47-3.20; P < .001), and Ki-67 status (OR, 3.57; 95% CI, 2.29-5.58; P < .001) had significant value as independent predictors of ALNM. Only the internal echo (OR, 1.95; 95% CI, 1.28-2.95; P = .002) of breast cancer was an independent predictor of the Ki-67 status. The heterogeneity in the internal echo indicated faster cancer cell proliferation and was associated with a worse prognosis in patients with breast carcinoma.
Certain conventional US characteristics may be useful predictors of ALNM and the Ki-67 status in patients with breast cancer.
探讨乳腺癌患者乳腺肿瘤的超声（US）特征与腋窝淋巴结转移（ALNM）和 Ki-67 表达之间的关系。
共纳入 527 例连续接受 US 检查并接受腋窝淋巴结评估的乳腺癌根治性手术患者。采用常规 US 观察腋窝淋巴结或原发性乳腺病变的大小、形状、纵横比、边缘、内部回声、内部钙化、后方回声衰减、淋巴结门结构、皮质厚度和血流。确定病理预后因素，包括肿瘤的组织学类型、组织学分级、雌激素和孕激素受体状态、淋巴结状态和 Ki-67 表达。采用 logistic 回归模型评估原发性乳腺病变的 US 特征与 ALNM 和 Ki-67 表达的关系。
最大肿瘤直径（比值比 [OR]，1.54；95%置信区间 [CI]，1.05-2.27；P=0.028）、肿瘤边缘（OR，2.89；95% CI，1.69-4.94；P<0.001）、内部回声（OR，2.17；95% CI，1.47-3.20；P<0.001）和 Ki-67 状态（OR，3.57；95% CI，2.29-5.58；P<0.001）是 ALNM 的独立预测因子。只有乳腺癌的内部回声（OR，1.95；95% CI，1.28-2.95；P=0.002）是 Ki-67 状态的独立预测因子。乳腺癌内部回声的异质性提示癌细胞增殖较快，与乳腺癌患者的预后较差相关。
某些常规 US 特征可能是乳腺癌患者 ALNM 和 Ki-67 状态的有用预测指标。
