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超声造影在不同分子亚型乳腺癌鉴别诊断中的应用。

Application of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Different Molecular Subtypes of Breast Cancer.

机构信息

Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, Harbin, China.

出版信息

Ultrason Imaging. 2020 Nov;42(6):261-270. doi: 10.1177/0161734620959780.

Abstract

To explore the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of molecular subtypes of breast cancer. Sixty-two cases of breast cancer were divided into luminal epithelium A or B subtype (luminal A/B), Her-2 over-expression subtype and triple negative subtype (TN). CEUS and routine ultrasonography were performed for all patients before surgery. (1) The luminal epithelium subtype contrast enhancement pattern was more likely to present with radial edge (76.92%, < 0.05) and low perfusion (69.23%, < 0.05). The maximum intensity (IMAX) was lower in the luminal epithelium subtype ( < 0.05). (2) The Her-2 over-expression subtype contrast enhancement pattern was more likely to present with centripetal enhancement (93.75%, < 0.05) and perfusion defect (75.0%, < 0.05), and the time to peak (TTP) was shorter (80.0%, < 0.05). (3) The contrast enhancement pattern of the triple negative subtype was shown to have a clear boundary. Compared to the other two subtypes, the triple negative subtype did not have significantly different perfusion parameters ( > 0.05). (4) Our study showed that the areas under the ROC curve for radial edge, low perfusion and IMAX for the luminal epithelium subtype breast lesions were 76.5%, 75.6%, and 82.1%, respectively. Additionally, the areas under the ROC curve for centripetal enhancement, perfusion defect and TTP for the Her-2 over-expression subtype breast lesions were 68.6%, 92.4%, and 97.8%, respectively. The sensitivity, specificity, and diagnostic accuracy of clear boundaries in detecting triple negative subtype breast lesions were 90.5%, 80.0%, and 91.9%, respectively.

摘要

探讨超声造影(CEUS)在乳腺癌分子亚型鉴别诊断中的价值。将 62 例乳腺癌患者分为 luminal 上皮 A 或 B 型(luminal A/B)、Her-2 过表达型和三阴性型(TN)。所有患者术前均行 CEUS 和常规超声检查。(1)luminal 上皮型增强模式更倾向于呈现放射状边缘(76.92%, < 0.05)和低灌注(69.23%, < 0.05)。luminal 上皮型的最大强度(IMAX)较低( < 0.05)。(2)Her-2 过表达型增强模式更倾向于呈现向心性增强(93.75%, < 0.05)和灌注缺损(75.0%, < 0.05),达峰时间(TTP)较短(80.0%, < 0.05)。(3)三阴性型的增强模式表现为边界清晰。与其他两型相比,三阴性型的灌注参数无明显差异( > 0.05)。(4)本研究显示,luminal 上皮型乳腺癌病变的放射状边缘、低灌注和 IMAX 的 ROC 曲线下面积分别为 76.5%、75.6%和 82.1%。此外,Her-2 过表达型乳腺癌病变的向心性增强、灌注缺损和 TTP 的 ROC 曲线下面积分别为 68.6%、92.4%和 97.8%。检测三阴性型乳腺癌病变的清晰边界的敏感性、特异性和诊断准确性分别为 90.5%、80.0%和 91.9%。

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