三维超声汇聚征在乳腺肿块诊断及预后评估中的价值

摘要

Objective To investigate the value of retraction phenomenon at three-dimensional ultrasonogra-phy(3D-US) in diagnosis and prognosis evaluation in breast lesions .Methods 165 patients with breast lesions who underwent 3D-US examination were included .The presence of the retraction phenomenon in the coronal plane was e-valuated.Pathologic prognostic factors , including tumor size , histologic grade , lymph node status , estrogen receptor (ER), progesterone receptor(PR) status, human epidermal growth factor receptor 2(Cerb-B2) and Ki-67 expression were determined .The correlation of the retraction phenomenon and prognostic factors was analyzed .Results The sensitivity and specificity of retraction phenomenon in the diagnosis of breast cancers were 67.7%and 93.1%respec-tively.The detection rates of the retraction phenomenon in the invasive cancer and the non -invasive cancer were 80.3%and 11.8%( P<0.001 ) .The retraction phenomenon was correlated to the tumor size , histologic grade , es-trogen and progesterone receptor status .Compared with the breast cancer without the retraction phenomenon , the tumor size with the retraction phenomenon was more likely to show a smaller diameter less than 2 cm(P<0.05), a lower histologic grade with grade Ⅱ( P<0.05 ) , and a higher positive rate of ER and PR ( P<0.05 ) .The lymph node status and the expression of the CerB-2 and Ki-67 in the two groups had no significant difference ( P>0.05 ) . Conclusion The retraction phenomenon of three-dimensional US may be useful in the diagnosis and prognosis evalu-ation in breast lesions .%目的：探讨三维超声汇聚征在乳腺肿块诊断及预后评估中的价值。方法对165例乳腺肿块患者术前行三维超声检查，观察肿块冠状面汇聚征的表达情况，并与肿块直径、组织学分级、淋巴结状态以及雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子-2（CerbB-2）及Ki-67结果作比较，统计分析汇聚征与上述指标间关系。结果汇聚征诊断乳腺恶性肿块的灵敏度为67.7％，特异度为93.1％。汇聚征显示率在浸润性癌和非浸润性癌间差异有统计学意义（ P＜0.01）。汇聚征显示率与直径、组织学分级以及ER、PR表达有关。与无汇聚征组相比，有汇聚征组的肿块直径多≤2 cm（P＜0.05），组织学分级多为Ⅱ级（P＜0.05），且ER、PR的阳性率较高（ P＜0.05）。两组的淋巴结状态、CerbB-2及Ki-67表达之间差异无统计学意义（ P＞0.05）。结论三维超声汇聚征表达情况有助于乳腺癌预后评估，从而为临床治疗方案的制定提供更多有效影像学信息。