超声光散射诊断乳腺癌及其与VEGF表达的相关性研究

摘要

Objective: To investigate the correlation between synthesis diagnostic index (SDI) of diffused optical tomography(DOT) with ultrasonography(US) location detected preoperative and Vascular endothelial growth factor expression detected postoperative in breast cancer as well as their relationship with clinicopathological characteristics of breast cancer. Methods: Conventional DOT with US were performed on 131 cases of breast benign mass and 142 cases of breast cancer. SDI was measured. The receiver operating characteristic (ROC) curve analysis was used to estimate the optimal diagnostic threshold of breast cancer. The expression levels of VEGF was detected by SP immunohistochemistry. Analysis the correlation between SDI and the expression levels of VEGF. Analysis the correlation between SDI as well as the expression of HIF-1 α and clinicopathological characteristics of breast cancer. Results: The mean value of SDI was 109.35 ± 48.03 in the breast benign mass and 190.87 ±60.33 in the breast cancer. There were significant difference between them (P＜0.01). According to ROC curve analysis, the areas under ROC curve of SDI was 0.889, the SDI value greater than 141.2 was an optimal diagnostic threshold of breast cancer. The SDI was significantly higher in VEGF-positive breast cancer than in VEGF- negative breast cancer(P＜0.01).The mean value of SDI and the expression levels of VEGF were significantly correlated with the tumor size, lymph node status ,clinical TNM stage and the expression levels of cerbB-2 (P＜0.01), while had no correlation with the expression levels of ER and PR(P＞0.05). Conclusion: As a new technology of functional imaging, DOT with US location might play a great role of early diagnosis and distinguishing benign from malignant tumor.%目的:探讨乳腺癌超声光散射断层成像综合诊断指数(SDI)与血管内皮生长因子(VEGF)的关系以及它们与乳腺癌临床病理特征的关系.方法:采用超声光散射乳腺断层成像系统研究131例乳腺良性疾病及142例乳腺癌患者,测量超声光散射断层成像SDI,通过受试者工作特征(ROC)曲线确定乳腺癌的最佳诊断阈值.使用免疫组织化学SP法检测VEGF在乳腺癌组织中的表达.分析SDI值与VEGF表达的关系.分析SDI值以及VEGF表达与乳腺癌临床病理特征的关系.结果:乳腺良性疾病与乳腺癌的SDI值分别为109.35±48.03、190.87±6033,两者之间差异有统计学意义(P＜0.01).经ROC曲线分析可得:SDI值的ROC曲线下面积为0.889,以SDI值＞141.2作为乳腺癌的最佳诊断阈值.VEGF表达阳性的乳腺癌组织,SDI值高于VEGF表达阴性的乳腺癌组织(P＜0.01).SDI值、VEGF表达与乳腺癌肿瘤大小、淋巴结转移、TNM分期、cerbB-2表达有关(P＜0.01),与雌、孕激素受体(ER、PR)表达无关(P＞0.05).结论:超声光散射作为一种新的功能性检测技术对乳腺癌的诊断、病情判断方面有重要的指导意义.