标题：乳腺癌患者HFUS图像与Ki-67、Her-2、PR、ER表达的相关性

      作者：张宝方 1，黄穗 2，李少英 3，夏勇 4，陈瑞瑞 5，林小影 1    深圳市宝安区妇幼保健院超声医学科 1、病理科 2、乳甲科 3、中心实验室 4、保健部 5，广东 深圳 518101

      卷次： 2021年32卷15期

      【摘要】 目的 探讨乳腺癌患者高频超声(HFUS)图像与增殖细胞核抗原(Ki-67)、原癌基因(Her-2)、孕激素受体(PR)、雌激素受体(ER)表达的相关性。方法 回顾性分析深圳市宝安区妇幼保健院2017年10月至2020年12月接诊的 110例乳腺癌患者临床资料，记录所有患者HFUS图像表现及Ki-67、Her-2、PR、ER阳性率表达情况，采用Spearman相关性分析HFUS图像和Ki-67、Her-2、PR、ER的相关性。结果 乳腺癌组织中Ki-67的阳性率为67.27% (74/110)，Her-2的阳性率为 28.18% (31/110)，PR的阳性率为 50.91% (56/110)，ER的阳性率为 67.27% (74/110)；Ki-67在肿块大小≥2 cm、无微钙化及无毛刺征中的阳性率分别为77.19%、77.19%、80.00%，明显高于肿块大小<2 cm、有微钙化及毛刺征的56.60%、56.60%、56.67%，差异均有统计学意义(P<0.05)；Her-2在肿块大小≥2 cm、血流分级Ⅱ~Ⅲ级、有淋巴结转移中的阳性率分别为38.60%、36.51%、40.00%，明显高于肿块大小<2 cm、血流分级0~1级、无淋巴结转移的16.98%、17.02%、16.36%，差异均有统计学意义(P<0.05)；PR在肿块大小<2 cm、后方回声有衰减中的阳性率分别为62.26%、73.08%，明显高于肿块大小≥2 cm、后方回声无衰减的40.35%、44.05%，差异均有统计学意义(P<0.05)；ER在肿块大小<2 cm、无淋巴结转移中的阳性率分别为 77.36%、77.36%，明显高于肿块大小≥2 cm、有淋巴结转移的57.89%、58.18%，差异均有统计学意义(P<0.05)；经Spearman相关性分析显示，Ki-67与肿块钙化、毛刺征呈负相关性(P<0.05)，Her-2与肿块大小、淋巴结转移呈正相关(P<0.05)，PR与后方回声呈正相关(P<0.05)，ER与肿块大小呈负相关(P<0.05)。结论 乳腺癌患者HFUS超声图像与Ki-67、Her-2、PR、ER表达有一定相关性，对其检测有助于评估患者病情，临床应用价值高。
      【关键词】 乳腺癌；高频超声；增殖细胞核抗原；原癌基因；孕激素受体；雌激素受体；相关性
      【中图分类号】R737.9 【文献标识码】 A 【文章编号】 1003—6350（2021）15—1934—05

Correlation between HFUS features and the expression of Ki-67, HER-2, proto oncogene, and estrogen receptorin patients with breast cancer.
ZHANG Bao-fang 1, HUANG Sui 2, LI Shao-ying 3, XIA Yong 4, CHEN Rui-rui 5, LINXiao-ying 1. Department of Ultrasound Medicine 1, Department of Pathology 2, Department of Mastidaceae 3, CentralLaboratory 4, Department of Health 5, Shenzhen Bao'an Womens and Children's Hospital, Shenzhen 518101, Guangdong,CHINA
【Abstract】 Objective To study the correlation between high frequency ultrasound (HFUS) features and the ex-pression of proliferating cell nuclear antigen (Ki-67), proto oncogene (Her-2), proto oncogene (PR) and estrogen recep-tor (ER) in patients with breast cancer. Methods The clinical data of 110 patients with breast cancer in ShenzhenBao'an Women's and Children's Hospital from January 2019 to December 2020 were retrospectively analyzed. TheHFUS signs and the positive rates of Ki-67, Her-2, PR and ER were recorded. Pearson correlation was used to analyzethe correlation between HFUS and Ki-67, Her-2, PR and ER. Results The positive rate of Ki-67, Her-2, PR, ER inbreast cancer tissue was 67.27% (74/110), 28.18% (31/110), 50.91% (56/110), 67.27% (74/110), respectively. The posi-tive rate of Ki-67 in the tumor with size≥2 cm, those without microcalcification, and those without burr signs were77.19%, 77.19%, and 80.00%, respectively, which were significantly higher than 56.60%, 56.60%, 56.67% in the tumorwith size<2 cm, with microcalcification, and those with burr signs (P<0.05). The positive rates of Her-2 in the tumorwith size≥2 cm, blood flow gradeⅡ toⅢ, and lymph node metastasis were 38.60%, 36.51%, and 40.00%, which weresignificantly higher than 16.98%, 17.02%, 16.36% of the tumor with size<2 cm, blood flow grade 0-1, and those withoutlymph node metastasis (P<0.05). The positive rates of PR in the tumor with size<2 cm and in those with rear echo attenu-ation were 62.26% and 73.08%, which were significantly higher than 40.35% and 44.05% of the tumor with≥2 cm andthose without rear echo attenuation (P<0.05). The positive rates of ER in tumor with size<2 cm and those without lymphnode metastasis were 77.36% and 77.36%, which were significantly higher than 57.89% and 58.18% of the tumor withsize≥2 cm and those with lymph node metastasis (P<0.05). Spearman correlation analysis showed that Ki-67 was nega-tively correlated with calcification and spicule sign, HER-2 was positively correlated with tumor size and lymph nodemetastasis, PR was positively correlated with posterior echo, and ER was negatively correlated with tumor size (P<0.05).