Wang Hui, Li Cui-Ying, Zha Hai-Ling, Xu Di, Hu Zhi-Bin
Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China.
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China.
Cancer Manag Res. 2021 Feb 4;13:1017-1028. doi: 10.2147/CMAR.S292944. eCollection 2021.
To investigate the diagnostic and predictive value of strain ratios in the regions of interests (ROIs) in reference tissue for breast tumor.
A total of 707 lesions in 665 consecutive patients were examined with B-mode Breast Imaging-Reporting and Data System (BI-RADS) and Ultrasonic elastography (UE). Elasticity score (ES) and strain ratio (SR) in each lesion were calculated. Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of BI-RADS, ES, SR1, SR2, BI-RADS combined with ES (BI-RADS+ES), BI-RADS combined with SR1 (BI-RADS+SR1), and BI-RADS combined with SR2 (BI-RADS+SR2). The sensitivity, specificity, and areas under the ROC curves (Az) were obtained. Scatter plots were generated to demonstrate the correlation between SR1 and SR2. Kruskal-Walls -test, Mann-Whitney -test and one-way ANOVA were performed to evaluate SRs and tumor-related variables. Multiple linear regression analysis was carried out to determine variables independently associated with SRs.
BI-RADS had high sensitivity and low specificity in the diagnosis of breast tumor. The specificity of BI-BADS combined with ES or SR was even higher. The Az value of BI-RADS+ES or BI-RADS+SRs was higher than that of BI-RADS ( < 0.001). The Az value of ES was higher than those of SR1 and SR2 ( < 0.001), and those of SR1 and SR2 were similar. SR1 and SR2 were highly positively correlated. There was no statistical difference between Az values of BI-RADS+ES, BI-RADS+SR1, and BI-RADS+SR2. Indistinct margin, high histologic grade, histological type, and negative human epidermal growth factor receptor (Her-2) were associated with SR1 and SR2. Progesterone receptor (PR) status and molecular subtype were associated with SR2. Histologic grade and tumor margin were significantly associated with SR1, and tumor margin was associated with SR2.
SRs in different ROIs in the reference tissue at the same depth showed no different diagnostic value for breast tumor. Both SR1 and SR2 could be useful in assessing the biological characteristics of invasive breast carcinoma.
探讨参考组织中感兴趣区域（ROI）的应变率对乳腺肿瘤的诊断及预测价值。
对665例连续患者的707个病灶进行B型乳腺影像报告和数据系统（BI-RADS）及超声弹性成像（UE）检查。计算每个病灶的弹性评分（ES）和应变率（SR）。采用受试者操作特征（ROC）曲线评估BI-RADS、ES、SR1、SR2、BI-RADS联合ES（BI-RADS+ES）、BI-RADS联合SR1（BI-RADS+SR1）以及BI-RADS联合SR2（BI-RADS+SR2）的诊断价值。获得敏感性、特异性及ROC曲线下面积（Az）。绘制散点图以展示SR1与SR2之间的相关性。进行Kruskal-Walls检验、Mann-Whitney检验及单因素方差分析以评估应变率及肿瘤相关变量。开展多元线性回归分析以确定与应变率独立相关的变量。
BI-RADS在乳腺肿瘤诊断中敏感性高但特异性低。BI-RADS联合ES或SR时特异性更高。BI-RADS+ES或BI-RADS+SRs的Az值高于BI-RADS（P<0.001）。ES的Az值高于SR1和SR2（P<0.001），且SR1和SR2的Az值相近。SR1与SR2高度正相关。BI-RADS+ES、BI-RADS+SR1及BI-RADS+SR2的Az值之间无统计学差异。边界不清、高组织学分级、组织学类型及人表皮生长因子受体（Her-2）阴性与SR1和SR2相关。孕激素受体（PR）状态及分子亚型与SR2相关。组织学分级及肿瘤边界与SR1显著相关，肿瘤边界与SR2相关。
同一深度参考组织中不同ROI的应变率对乳腺肿瘤的诊断价值无差异。SR1和SR2均可用于评估浸润性乳腺癌的生物学特征。
