超声弹性成像定量指标和半定量评分与乳腺肿瘤成纤维细胞分布的关联性分析

发布时间：2018-08-30 12:27

【摘要】：目的:探讨乳腺占位性病变超声弹性成像定量指标和半定量评分与成纤维细胞分布的关联性,阐明超声弹性成像定量指标和半定量评分在乳腺肿瘤诊断中的价值。方法:对38例乳腺占位性病变进行超声弹性成像检查,并对弹性图像进行定量分析,获得11个特征量及相应的弹性应变率比值,进行半定量评分,根据病理结果将其分为良性组和恶性组,采用免疫组织化学法分别检测乳腺间质穿膜糖蛋白(CD34)和α-平滑肌肌动蛋白(α-SMA)的表达,分析成纤维细胞在乳腺病变中的分布特征,研究乳腺弹性成像定量评价指标和半定量评分与成纤维细胞分布的关联性。结果:恶性组乳腺组织中CD34表达水平明显低于良性组,而恶性组α-SMA表达水平明显高于良性组,CD34和α-SMA在良性和恶性乳腺占位病变中表达水平比较差异有统计学意义(P0.01)。恶性组弹性成像以蓝色为主,良性组弹性成像以绿色为主,2组间弹性成像评分比较差异有统计学意义。CD34在乳腺肿瘤组织中的表达与弹性成像评分呈负相关关系(r=-0.423 7,P=0.027 3),α-SMA在乳腺肿瘤组织中的表达与弹性成像评分呈正相关性关系(r=0.397 0,P=0.014 2)。CD34与11个特征量中应变均值及均等性、蓝色区域百分比、峰度、偏度、杂乱度均有相关性(P0.05),其中与应变均值(r=0.385 6,P=0.016 8)及均等性(r=0.380 5,P=0.018 5)呈正相关关系,与蓝色区域百分比(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)、杂乱度(r=-0.344 3,P=0.034 3)、一致性(r=-0.484 9,P=0.002 0)及弹性应变率比值(r=-0.379 0,P=0.047 5)呈负相关关系,与标准偏差、复杂度、相关性和对比度无相关性(P0.05);而α-SMA与峰度(r=0.356 9,P=0.027 8)和偏度(r=0.323 0,P=0.047 9)、蓝色区域百分比(r=0.382 0,P=0.021 6)以及弹性应变率比值(r=0.403 3,P=0.012 0)有相关性,并呈正相关关系。结论:超声弹性成像定量指标和半定量评分与成纤维细胞在乳腺肿瘤中的分布具有相关性,有助于在术前通过无创手段初步判断患者预后,可为乳腺癌的术前诊断、治疗和手术时机选择提供重要参考依据。
[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 伪 -smooth muscle actin (伪 -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 伪 -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 伪 -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 伪 -SMA and contrast (P0.05), but 伪 -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 伪 -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.
【作者单位】：辽宁医学院航天中心医院研究生培养基地超声科;辽宁医学院航天中心医院研究生培养基地病理科;
【基金】：辽宁医学院航天中心医院院内项目资助课题(YN201406)
【分类号】：R737.9;R445.1

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