乳腺浸润性导管癌超声微钙化征象与PR ER HER-2 P53 TOPIIa ck5/6 KI67表达的相关性

吴昊 冯佩明 张可新 吴文瑛

摘要：目的：探索乳腺浸润性导管癌超声内部微钙化征象的出现与雌激素受体ER，孕激素受体PR，人类表皮生长因子2HER-2，p53，DNA拓扑异构酶IIaTOPIIa，细胞角蛋白ck5/6，细胞核抗体KI67等免疫组化因子表达的相关性。方法：收集承德医学院附属医院2020年1月至2021年7月手术治疗的乳腺浸润性导管癌患者350例，术前进行超声检查并留存有标准的超声声像图，并运用χ²、Spearman与二元logistic回归依次分析超声微钙化征象与各个免疫组化因子表达的相关性。结果：浸润性导管癌微钙化征象的出现与HER-2、P53、KI67、TOPIIa、CK5/6的表达具有统计学意义（P<0.05），与ER、PR的表达无统计学意义（P>0.05）。结论：乳腺浸润性导管癌超声微钙化征象的出现与HER-2、P53、KI67、topIIa、CK5/6的表達有统计学意义，超声微钙化征象的出现对判断乳腺癌的预后有预测价值。

关键词：超声;乳腺癌;微钙化;免疫组化

【中图分类号】R737 【文献标识码】A 【文章编号】1673-9026（2021）15--03

Abstract：Objective： To explore the correlation between the appearance of ultrasonic microcalcification signs and the expression of estrogen receptor ER， progesterone receptor PR， human epidermal growth factor 2HER-2， p53，DNA topoisomerase IIaTOPIIa， cytokeratin CK5/6， nuclear antibody KI67 and other immunohistochemical factors in invasive ductal carcinoma of breast.Methods： 350 patients with invasive ductal carcinoma of breast who received surgical treatment from The Affiliated Hospital of Chengde Medical College from January 2020 to July 2021 were collected. Preoperative ultrasound examination was performed and standard ultrasound images were retained. χ² Spearman and binary logistic regression were used to analyze the correlation between ultrasonic microcalcification signs and the expression of various immunohistochemical factors.Results： The microcalcification signs of invasive ductal carcinoma were statistically significant with the expression of HER-2， P53， KI67， TOPIIa and CK5/6 （P<0.05）， and had no statistical significance with the expression of ER and PR （P<0.05）.Conclusion： The appearance of ultrasonic microcalcification signs in invasive ductal carcinoma of breast has statistical significance with the expression of HER-2， P53， KI67， topIIa and CK5/6， and the appearance of ultrasonic microcalcification signs has predictive value for the prognosis of breast cancer.

Key words：ultrasound; Breast cancer; Microcalcification; immunohistochemical

乳腺癌是全世界女性中发病率最高的癌症【1】。早期诊断乳腺癌目前主要依靠彩色多普勒超声，钼靶，核磁等，而超声由于其无电离辐射，可显示血流信号等优势被广泛应用于乳腺疾病的早期筛查。随着分子生物学的发展，人们认识到乳腺癌的发生发展与其基因表达等因素关系密切。乳腺癌中浸润性导管癌占80%以上，本研究主要探究超声微钙化征象与PR、ER、HER-2、P53、ck5/6、KI67和TOPIIa表达的相关性。

一、资料与研究方法

1.1资料

选择2020年1月至2021年7月在我院手术病理证实的乳腺浸润性导管癌患者350例，年龄32-84岁，所有患者均为女性，超声检查、病理及免疫组化结果完整，术前未经任何治疗。……