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【摘要】：目的:探討乳腺占位性病變超聲彈性成像定量指標和半定量評分與成纖維細胞分布的關聯(lián)性,闡明超聲彈性成像定量指標和半定量評分在乳腺腫瘤診斷中的價值。方法:對38例乳腺占位性病變進行超聲彈性成像檢查,并對彈性圖像進行定量分析,獲得11個特征量及相應的彈性應變率比值,進行半定量評分,根據(jù)病理結果將其分為良性組和惡性組,采用免疫組織化學法分別檢測乳腺間質(zhì)穿膜糖蛋白(CD34)和α-平滑肌肌動蛋白(α-SMA)的表達,分析成纖維細胞在乳腺病變中的分布特征,研究乳腺彈性成像定量評價指標和半定量評分與成纖維細胞分布的關聯(lián)性。結果:惡性組乳腺組織中CD34表達水平明顯低于良性組,而惡性組α-SMA表達水平明顯高于良性組,CD34和α-SMA在良性和惡性乳腺占位病變中表達水平比較差異有統(tǒng)計學意義(P0.01)。惡性組彈性成像以藍色為主,良性組彈性成像以綠色為主,2組間彈性成像評分比較差異有統(tǒng)計學意義。CD34在乳腺腫瘤組織中的表達與彈性成像評分呈負相關關系(r=-0.423 7,P=0.027 3),α-SMA在乳腺腫瘤組織中的表達與彈性成像評分呈正相關性關系(r=0.397 0,P=0.014 2)。CD34與11個特征量中應變均值及均等性、藍色區(qū)域百分比、峰度、偏度、雜亂度均有相關性(P0.05),其中與應變均值(r=0.385 6,P=0.016 8)及均等性(r=0.380 5,P=0.018 5)呈正相關關系,與藍色區(qū)域百分比(r=-0.351 7,P=0.030 4)、峰度(r=-0.427 7,P=0.007 4)、偏度(r=-0.394 6,P=0.014 2)、雜亂度(r=-0.344 3,P=0.034 3)、一致性(r=-0.484 9,P=0.002 0)及彈性應變率比值(r=-0.379 0,P=0.047 5)呈負相關關系,與標準偏差、復雜度、相關性和對比度無相關性(P0.05);而α-SMA與峰度(r=0.356 9,P=0.027 8)和偏度(r=0.323 0,P=0.047 9)、藍色區(qū)域百分比(r=0.382 0,P=0.021 6)以及彈性應變率比值(r=0.403 3,P=0.012 0)有相關性,并呈正相關關系。結論:超聲彈性成像定量指標和半定量評分與成纖維細胞在乳腺腫瘤中的分布具有相關性,有助于在術前通過無創(chuàng)手段初步判斷患者預后,可為乳腺癌的術前診斷、治療和手術時機選擇提供重要參考依據(jù)。
[Abstract]:Objective: to investigate the relationship between quantitative and semi-quantitative ultrasound elastography and fibroblast distribution in space-occupying lesions of mammary gland and to elucidate the value of quantitative and semi-quantitative ultrasound elastic imaging in the diagnosis of breast tumors. Methods: Elastography was performed in 38 cases of space-occupying lesions of mammary gland, and the quantitative analysis of elastic images was performed. Eleven characteristic quantities and the corresponding ratio of elastic strain rate were obtained, and the semi-quantitative score was obtained. According to the pathological results, it was divided into benign group and malignant group. The expression of interstitial glycoprotein (CD34) and 偽 -smooth muscle actin (偽 -SMA) were detected by immunohistochemical method, and the distribution characteristics of fibroblasts in breast lesions were analyzed. To study the relationship between quantitative evaluation index and semi-quantitative score of breast elastography and the distribution of fibroblasts. Results: the expression level of CD34 in malignant group was significantly lower than that in benign group, while the expression level of 偽 -SMA in malignant group was significantly higher than that in benign group (P0.01). The elastic imaging of malignant group was mainly blue. There was a negative correlation between the expression of CD34 in breast tumor tissue and the elastic imaging score (r-0.423 7), and the expression of 偽 -SMA in breast tumor tissue. There was a positive correlation between CD34 and elastic imaging score (r = 0.397 0 / 0. 0142). CD34 was correlated with the strain mean and equalization of 11 characteristic variables. The blue area percentage, kurtosis, skewness and disorder degree were all correlated (P0.05), and there was a positive correlation with the mean strain (r = 0.385 6) and equality (r = 0.3805 / P ~ (0.018). It has a negative correlation with the blue region percentage (r-0.3517), kurtosis (r-0.427 7), bias (r-0.394 6 ~ (6) P ~ (+) 0.0142), clutter degree (r ~ (-0.344 3) P ~ (0.034), consistency (r ~ (-0.484 9) P ~ (0.0020) and elastic strain rate ratio (r _ (0) -0.379 ~ (0) P ~ (0.047), and is negatively related to standard deviation, complexity, and complexity. There was no correlation between 偽 -SMA and contrast (P0.05), but 偽 -SMA was correlated with kurtosis (r = 0.356 9), bias (r = 0.323 0), blue area percentage (r = 0.382 0) and elastic strain rate ratio (r = 0.403 3P 0.0120), and there was a positive correlation between 偽 -SMA and kurtosis (r = 0.323, P = 0.027), blue area percentage (r = 0.382 0, P = 0.021) and elastic strain rate ratio (r = 0.403, P 0.0120). Conclusion: the quantitative indexes and semi-quantitative scores of ultrasound elastography have a correlation with the distribution of fibroblasts in breast tumors, which is helpful for the preliminary evaluation of the prognosis of breast cancer by non-invasive means before operation, and can be used for the preoperative diagnosis of breast cancer. The choice of treatment and operation timing provides important reference basis.
【作者單位】： 遼寧醫(yī)學院航天中心醫(yī)院研究生培養(yǎng)基地超聲科;遼寧醫(yī)學院航天中心醫(yī)院研究生培養(yǎng)基地病理科;
【基金】：遼寧醫(yī)學院航天中心醫(yī)院院內(nèi)項目資助課題(YN201406)
【分類號】：R737.9;R445.1

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本文編號：2213068