标题：超声弹性成像参数在浸润性乳腺癌诊断中的应用及其与组织NKD1、HER-2表达量的关系

      作者：连俊，李苗，伍玉容，梁汝娜    安康市中心医院超声科，陕西 安康 725000

      卷次： 2022年33卷14期

      【摘要】 目的 探究超声弹性成像参数在浸润性乳腺癌诊断中的应用价值及其与组织裸角质膜同源蛋白(NKD1)、人表皮生长因子受体-2 (HER-2)表达量的关系。方法 选取2019年2月至2021年6月安康市中心医院收治的90例浸润性乳腺癌(乳腺癌组)和68例乳腺良性肿瘤(对照组)为研究对象，所有患者均采用超声弹性成像。比较两组患者的AR值及硬度评分，采用受试者工作特征曲线(ROC)分析其对浸润性乳腺癌的诊断价值；比较乳腺癌组患者癌组织及癌旁组织的NKD1、HER-2表达量，采用Pearson检验分析癌组织NKD1、HER-2表达量与弹性评分及AR值的相关性。结果 乳腺癌组患者的AR值大于对照组(1.53±0.25) vs (1.39±0.21)，硬度评分高于对照组[(4.32±0.37)分 vs (2.85±0.22)分]，差异均有统计学意义(P<0.05)；超声弹性成像参数联合检测诊断浸润性乳腺癌的AUC大于AR值单独检测(0.765 vs 0.659)，差异有统计学意义(P<0.05)；癌组织NKD1表达量低于癌旁组织，HER-2mRNA表达量高于癌旁组织(0.56±0.11) vs (0.64±0.12)；(0.63±0.13) vs (0.45±0.08)，差异均有统计学意义(P<0.05)；硬度评分≥3.97分患者癌组织 NKD1表达量低于<3.97分患者，HER-2 mRNA表达量高于<3.97分患者 (0.54±0.10) vs (0.65±0.13)；(0.65±0.12) vs (0.54±0.10)，AR值≥1.48患者癌组织 NKD1表达量低于<1.48患者，HER-2mRNA表达量高于<1.48患者 (0.53±0.11) vs (0.66±0.13)；(0.65±0.13) vs (0.56±0.09)，差异均具有统计学意义(P<0.05)；癌组织 NKD1表达量与硬度评分及 AR值呈负相关 (r=-0.498、-0.432，P<0.05)，HER-2 mRNA表达量与AR值呈正相关(r=0.336，P<0.05)。结论 超声弹性成像参数联合检测对浸润性乳腺癌具有诊断价值，且AR值及硬度评分与癌组织NKD1、HER-2 mRNA表达量均相关。
      【关键词】 浸润性乳腺癌；超声弹性成像；裸角质膜同源蛋白；人表皮生长因子受体-2；诊断价值；相关性
      【中图分类号】 R737.9 【文献标识码】 A 【文章编号】 1003—6350（2022）14—1852—04

Application of ultrasound elastography parameters in the diagnosis of invasive breast cancer and theirrelationship with NKD1 and HER-2 expression.
LIAN Jun, LI Miao, WU Yu-rong, LIANG Ru-na. Department ofUltrasonography, Ankang Central Hospital, Ankang 725000, Shaanxi, CHINA
【Abstract】 Objective To explore the application value of ultrasound elastography (UE) parameters in the diag-nosis of invasive breast cancer and their relationship with naked cuticle drosophila 1 (NKD1) and human epidermalgrowth factor receptor-2 (HER-2) expression. Methods A total of 90 patients with invasive breast cancer (breast can-cer group) and 68 patients with benign breast tumors (control group) admitted to Ankang Central Hospital between Feb-ruary 2019 and June 2021 were enrolled as the research objects. All the patients underwent UE. AR value and hardnessscore between the two groups were compared, and their diagnostic value for invasive breast cancer was analyzed by re-ceiver operating characteristic (ROC) curves. The expression levels of NKD1 and HER-2 in cancer tissues and para-carci-noma tissues in breast cancer group were compared. The correlation between NKD1, HER-2 expression in cancer tissuesand elasticity score, AR value was analyzed by Pearson test. Results AR value in breast cancer group was greater thanthat in control group, and hardness score was higher than that in control group: (1.53±0.25) points vs (1.39±0.21) points,(4.32±0.37) points vs (2.85±0.22) points, P<0.05. AUC of combined detection with UE parameters in the diagnosis of in-vasive breast cancer was greater than that of AR alone (0.765 vs 0.659, P<0.05). The expression level of NKD1 in cancertissues was lower than that in para-carcinoma tissues, while expression level of HER-2 mRNA was higher than that inpara-carcinoma tissues: (0.56±0.11) vs (0.64±0.12), (0.63±0.13) vs (0.45±0.08), P<0.05. The expression level of NKD1in patients with hardness score ≥3.97 points was lower than that in patients with hardness score <3.97 points, while ex-pression level of HER-2 mRNAwas higher: (0.54±0.10) vs (0.65±0.13), (0.65±0.12) vs (0.54±0.10), P<0.05. The expres-sion level of NKD1 in patients with AR≥1.48 was lower than that in patients with AR<1.48, while expression level ofHER-2 mRNA was higher: (0.53±0.11) vs (0.66±0.1), (0.65±0.13 3) vs (0.56±0.09), P<0.05. The expression level ofNKD1 in cancer tissues was negatively correlated with hardness score and AR value (r=-0.498, -0.432, P<0.05), and ex-pression level of HER-2 mRNA was positively correlated with AR value (r=0.336, P<0.05). Conclusion The com-bined detection of UE parameters is of great diagnostic value for invasive breast cancer. AR value and hardness score arerelated to expression levels of NKD1 and HER-2 mRNA in cancer tissues.
      【Key words】 Invasive breast cancer; Ultrasound elastography; Naked cuticle drosophila 1; Human epidermalgrowth factor receptor-2; Diagnostic v