Liu Xu, Li Jigang, He Ying, Wang Zhiyuan
Ultrasound Diagnosis Center, Hunan Cancer Hospital, Changsha 410013.
Department of Clinical Pathology, Hunan Cancer Hospital, Changsha 410013.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Dec 28;49(12):1941-1952. doi: 10.11817/j.issn.1672-7347.2024.240398.
Shear wave elastography (SWE) is a novel quantitative elastography technique that can assess the hardness of different tissues. This study introduces a novel shear wave parameter-frequency of mass characteristic ()-and investigates its correlation, along with other shear wave parameters, with the histopathological features and immunohistochemical (IHC) biomarkers of invasive breast cancer (IBC). The study aims to explore whether SWE can provide useful information for IBC treatment and prognosis.
With the pathological results as the gold standard, 258 malignant breast lesions were collected, and all patients underwent conventional ultrasound and SWE examinations. The SWE parameters [maximum elastic value (E), minimum elastic value (E), mean elastic value (E), standard deviation of elastic value of the whole lesion (E)] and ] in the transverse and longitudinal orthogonal sections were measured, and their correlations with the prognostic factors of IBC [including tumor diameters, axillary lymph node (ALN) metastasis, lymphatic vessel invasion (LVI), calcification, histological type, histological grade, and IHC biomarkers (ER, PR, HER-2, Ki-67), and molecular subtypes] were analyzed. The correlations between the SWE parameters of the transverse and longitudinal sections of the tumors with different prognostic factors and the above indicators were analyzed. At the same time, the receiver operating characteristic (ROC) curve was used to analyze the efficacy of in predicting ER and PR expression.
E, E, E, and were correlated with tumor diameters; E, E and E were correlated with histological types and histological grades. E and E were correlated with ALN metastasis, LVI and pathological types. In the IHC biomarker-labeled masses, was correlated with ER and PR (both <0.05), and E, E, and E were correlated with HER-2 and Ki-67 (all <0.05). E, E, and were all correlated with breast cancer subtypes (all <0.05), and E and E were higher in Luminal B [HER-2(+)] breast cancer, while was lower in HER-2(+) and triple-negative breast cancer. Among the statistically significant prognostic factors, the values of the transverse sections of the masses were all less than or equal to those of the longitudinal sections. The AUC of in the transverse sections of the masses for predicting ER and PR expression were 0.73 (95% 0.65 to 0.80) and 0.67 (95% 0.60 to 0.74), respectively, with the optimal cut-off values being 76.50 and 60.66, the sensitivities being 72.45% and 81.98%, the specificities being 66.13% and 45.35%, and the accuracies being 70.93% and 69.77%, respectively. The AUC of in the longitudinal sections of the masses for predicting ER and PR expression were 0.74 (95% 0.67 to 0.81) and 0.65 (95% 0.58 to 0.72), respectively, with the optimal cut-off values being 131.8 and 137.5, the sensitivities being 69.90% and 66.28%, the specificities being 72.58% and 60.47%, and the accuracies being 70.54% and 64.34%, respectively. The in the transverse sections of the masses was more statistically significant.
The poor prognosis factors of IBC are related to high E, E, E, E, and low . The can predict the expression of ER and PR, and the transverse cut data are more meaningful. SWE is helpful for predicting the invasiveness of IBC.
剪切波弹性成像(SWE)是一种新型定量弹性成像技术,可评估不同组织的硬度。本研究引入一种新型剪切波参数——肿块特征频率(),并研究其与其他剪切波参数以及浸润性乳腺癌(IBC)的组织病理学特征和免疫组化(IHC)生物标志物之间的相关性。本研究旨在探讨SWE是否可为IBC的治疗和预后提供有用信息。
以病理结果为金标准,收集258例乳腺恶性病变,所有患者均接受常规超声和SWE检查。测量横、纵正交切面的SWE参数[最大弹性值(E)、最小弹性值(E)、平均弹性值(E)、整个病变弹性值的标准差(E)]及,分析其与IBC预后因素[包括肿瘤直径、腋窝淋巴结(ALN)转移、淋巴管浸润(LVI)、钙化、组织学类型、组织学分级以及IHC生物标志物(ER、PR、HER-2、Ki-67)和分子亚型]的相关性。分析不同预后因素及上述指标的肿瘤横、纵切面SWE参数之间的相关性。同时,采用受试者操作特征(ROC)曲线分析预测ER和PR表达的效能。
E、E、E和与肿瘤直径相关;E、E和E与组织学类型和组织学分级相关。E和E与ALN转移、LVI和病理类型相关。在IHC生物标志物标记的肿块中,与ER和PR相关(均<0.05),E、E和E与HER-2和Ki-67相关(均<0.05)。E、E和均与乳腺癌亚型相关(均<0.05),Luminal B[HER-2(+)]型乳腺癌中E和E较高,而HER-2(+)型和三阴性乳腺癌中较低。在具有统计学意义的预后因素中,肿块横切面的值均小于或等于纵切面的值。肿块横切面预测ER和PR表达的AUC分别为0.73(95% 0.65至0.80)和0.67(95% 0.60至0.74),最佳截断值分别为76.50和60.66灵敏度分别为72.45%和81.98%,特异性分别为66.13%和45.35%,准确性分别为70.93%和69.77%。肿块纵切面预测ER和PR表达的AUC分别为0.74(95% 0.67至0.81)和0.65(95% 0.58至0.72),最佳截断值分别为131.8和137.5,灵敏度分别为69.90%和66.28%,特异性分别为72.58%和60.47%,准确性分别为70.54%和64.34%。肿块横切面的在统计学上更具意义。
IBC的不良预后因素与高E、E、E、E及低相关。可预测ER和PR的表达,横切面数据更有意义。SWE有助于预测IBC的侵袭性。