Objective To investigate the correlation between synthesis diagnostic index (SDI) of diffused optical tomography (DOT) with ultrasonography (US) localization and microvessel density (MVD) based on CD105,as well as the vascular endothelial growth factor (VEGF) and HIF-lα expression in breast cancer. Methods SDI were demonstrated by DOT with US location for 163 patients withbenign mass (whichrninclude 108 cases of typical breast benign lesions,31 cases of intraductal papillomatosis and 24 cases of atypia ductal hyperplasia), and for 167 patients with breast cancer (37 cases of ductal carcinoma in situ and 130 cases of invasive breast cancer). The receiver operating characteristic (ROC) curve analysis was used to estimate the optimal diagnostic threshold of breast cancer. The MVD based on CD105 and the expressions of VEGF and HIF-1α were detected by immunohistochcmistry on all the 167 cases of breast cancer. Correlation between SDI, MVD and the expressions of VEGF and HIF-1α in breast cancer was analyzed. Results ROC curve analysis showed that the SDI value was 0. 879 under the area of ROC curve. The SDI value>140. 81 was used as the optimal diagnostic threshold of breast cancer. The mean SDI values were 83. 46 ± 37. 47 for typical breast benign lesions cases. 130. 46 ± 59. 24 for intraductal papillomatosis cases, 142. 14 ± 64. 33 for atypia ductal hyperplasia cases,157. 81 ± 31. 86 for ductal carcinoma in situ cases and 190. 43 ± 61. 60 for invasive breast cancer cases. The mean SDI values were significantly different between typical breast benign lesions and all other groups, as well as the invasive breast cancers (P<0. 05). There was no statistical difference between intraductal papilloma,mammary dysplasia and invasive breast cancer(P>0. 05). The SDI value has linear correlation with MVD of breast cancer (P<0. 05). The SDI and MVD values were positively correlated with the VEGF and HIF-1α expression in breast cancer. Conclusions SDI-DOT with us is closely related to microvessel density as well as the expressions of VEGF and HIF-1α in breast cancer, which can indirectly reflect the angiogenic activity and tissue hypoxia. It also might play a great role in early diagnosis and in distinguishing benign vs. malignant tumors.%目的 通过研究乳腺癌超声光散射断层成像(diffused optical tomography,DOT)综合诊断指数(synthesis diagnostic index,SDI)以及CD105、血管内皮生长因子(vascular endothelial growth factor,VEGF)、缺氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)在乳腺癌中的表达,探讨乳腺癌超声DOT-SDI与微血管密度(microvessel density,MVD)、VEGF和HIF-1α表达的关系.方法 采用超声DOT系统,研究163例乳腺良性病变(含典型良性病变108例,乳腺导管内乳头状瘤31例,乳腺导管上皮不典型增生24例)和167例乳腺癌(含乳腺导管原位癌37例,乳腺浸润性癌130例),测量超声DOT-SDI.通过受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)确定乳腺癌的最佳诊断阈值.使用免疫组化法检测乳腺癌CD105标记的MVD、VEGF和HIF-1α的表达强度.分析乳腺癌SDI值、MVD值以及VEGF和HIF-1α表达的关系.结果 经ROC曲线分析得出:SDI值的ROC曲线下面积(area under the zone,AZ)为0.879,确定SDI值＞140.81作为乳腺癌的最佳诊断阈值.乳腺典型良性疾病、乳腺导管内乳头状瘤、乳腺上皮不典型增生、乳腺导管原位癌、乳腺浸润性癌的SDI值分别为:83.46±37.47、130.46±59.24、142.14±64.33、157.81±31.86、190.43±61.60.乳腺典型良性病变、乳腺浸润性癌与其他各组之间的差异有统计学意义(P＜0.05).乳腺导管内乳头状瘤、乳腺上皮不典型增生、乳腺导管原位癌三者之间的差异无统计学意义(P＞0.05).SDI值与MVD值呈正相关(r=0.682,P＜0.05).VEGF、HIF-1α表达阴性、阳性、强阳性乳腺癌的SDI值之间的差异有统计学意义(P＜0.05).结论 DOT-SDI与乳腺癌MVD、VEGF和HIF-1a表达密切相关,可以间接反映血管生成活性和组织缺氧对乳腺癌的诊断、病情判断具有重要指导意义.
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