Correlation analysis between mammography features of early-stage invasive breast ductal carcinoma with positive ER, negative HER2, negative lymph node and Oncotype DX21 gene assay results

王　婷; 刘　壮; 龚　敬; 姜　琳; 沈茜刚; 顾雅佳

doi:10.19401/j.cnki.1007-3639.2021.06.005

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Correlation analysis between mammography features of early-stage invasive breast ductal carcinoma with positive ER, negative HER2, negative lymph node and Oncotype DX21 gene assay results

更新时间：2025-12-31

- Correlation analysis between mammography features of early-stage invasive breast ductal carcinoma with positive ER, negative HER2, negative lymph node and Oncotype DX21 gene assay results
- China Oncology Vol. 31, Issue 6, Pages: 468-473(2021)
- 作者机构：
  
  1. 复旦大学附属肿瘤医院放射诊断科，复旦大学上海医学院肿瘤学系,上海,200032
  2. 复旦大学附属肿瘤医院病理科，复旦大学上海医学院肿瘤学系,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2021.06.005
  CLC：
- Published Online：09 July 2021，
  
  Published：09 July 2021
- 稿件说明：
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王　婷, 刘　壮, 龚　敬, 姜　琳, 沈茜刚, 顾雅佳 . ER阳性、HER2阴性、淋巴结阴性早期浸润性乳腺导管癌X线征象与Oncotype DX21基因检测结果间的相关性分析[J]. 中国癌症杂志, 2021, 31(6): 468-473.

王　婷, 刘　壮, 龚　敬, et al. Correlation analysis between mammography features of early-stage invasive breast ductal carcinoma with positive ER, negative HER2, negative lymph node and Oncotype DX21 gene assay results[J]. China Oncology, 2021, 31(6): 468-473.
王　婷, 刘　壮, 龚　敬, 姜　琳, 沈茜刚, 顾雅佳 . ER阳性、HER2阴性、淋巴结阴性早期浸润性乳腺导管癌X线征象与Oncotype DX21基因检测结果间的相关性分析[J]. 中国癌症杂志, 2021, 31(6): 468-473. DOI： 10.19401/j.cnki.1007-3639.2021.06.005.

王　婷, 刘　壮, 龚　敬, et al. Correlation analysis between mammography features of early-stage invasive breast ductal carcinoma with positive ER, negative HER2, negative lymph node and Oncotype DX21 gene assay results[J]. China Oncology, 2021, 31(6): 468-473. DOI： 10.19401/j.cnki.1007-3639.2021.06.005.

摘要

背景与目的：Oncotype DX21基因检测具有预后预测和辅助治疗决策的价值，但通过有创手术获取的检测样本无法完全表征肿瘤的整体情况，而乳腺X线摄影是一项无创、经济、操作简单的常规检查项目。若能找到影像标志物，则可以实现以非侵入方式获取相关基因表达量方面的信息，同样达到预测预后和复发风险概率的目的。探究雌激素受体（estrogen receptor，ER）阳性、人表皮生长因子受体2（human epidermal growth factor receptor 2，HER2）阴性、淋巴结阴性的早期浸润性乳腺导管癌患者的X线影像特征与Oncotype DX21基因检测结果间的相关性。方法：回顾性收集了282例于2017年9月—2019年6月在复旦大学附属肿瘤医院进行过乳腺X线检查以及Oncotype DX21基因检测的ER阳性、HER2阴性、淋巴结阴性的早期浸润性乳腺导管癌患者资料。采用单因素和多因素有序logistic回归分析X线征象与Oncotype DX21基因检测复发风险评分（recurrence score，RS）分级的相关性，采用单因素方差分析X线征象与RS分值的相关性。结果：单因素和多因素有序logistic回归分析结果一致表明，肿块边缘和钙化形态与RS分级显著相关（P0.05）。进一步检验发现边缘模糊肿块的平均RS值为33.6，与边缘清楚（18.4）、毛刺（24.9）、小分叶（27.3）、遮蔽（23.1）间存在差异。不定形钙化和点状钙化的RS均值间差异有统计学意义。结论：乳腺X线影像中的钙化形态和肿块边缘特征具有成为Oncotype DX21基因检测的影像标志物的潜力，为临床医师对患者进行个体化治疗方案的决策提供强有力的帮助。

Abstract

Background and purpose: The Oncotype DX21 gene assay holds great promise in prognostic prediction and adjuvant treatment decision-making

but the test samples obtained through invasive surgery can not completely represent the whole tumor. Mammography is a noninvasive

economical and simple routine examination. If imaging markers can be found

information about related gene expression quantity can be obtained in a noninvasive way

and the purpose of predicting prognosis and recurrence risk probability can also be achieved. This study explored the correlation between X-ray imaging characteristics and Oncotype DX21 gene assay results ［recurrence score (RS) and RS grades］ in patients with early-stage invasive ductal carcinoma who were ER-positive

HER2-negative and node-negative. Methods: Data of 282 patients with ER-positive

HER2-negative and node-negative early-stage invasive ductal carcinoma who underwent mammography and Oncotype DX21 gene assay in Fudan University Shanghai Cancer Center from Sep. 2017 to Jun. 2019

were retrospectively collected. Univariate and multivariate ordered logistic regression was used to analyze the correlation between X-ray imaging features and RS grading. One-way analysis of variance was used to analyze the correlation between X-ray imaging features and RS scores. Results: Univariate and multivariate ordered logistic regression analysis consistently showed that mass margins and calcification morphology were significantly correlated with RS grading (P0.05). It was further found that the RS mean value of mass with indistinct margins was 33.6

which was significantly different from circumscribed (18.4)

spiculated (24.9)

microlobulated (27.3)

and obscured margins (23.1). There were also significant differences in the RS mean value between amorphous calcification and punctate calcification. Conclusion: Calcification morphology and mass margins in mammograms have the potential to become imaging markers for Oncotype DX21 gene assay

providing a powerful tool for clinicians to make individualized treatment decisions.

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