Clinicopathological and immunohistochemical basis for sonographic characteristics of triple-negative invasive breast cancer

李佳伟; 时兆婷; 侯英敏

doi:10.19401/j.cnki.1007-3639.2019.01.006

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Clinicopathological and immunohistochemical basis for sonographic characteristics of triple-negative invasive breast cancer

更新时间：2026-01-27

- Clinicopathological and immunohistochemical basis for sonographic characteristics of triple-negative invasive breast cancer
- China Oncology Vol. 29, Issue 1, Pages: 37-44(2019)
- 作者机构：
  
  1. 复旦大学附属肿瘤医院超声科，复旦大学上海医学院肿瘤学系,上海,200032
  2. 上海市奉贤区奉城医院超声科,上海,201411
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2019.01.006
  CLC： R737.9;R445.1
- Published Online：01 February 2019，
  
  Published：01 February 2019
- 稿件说明：
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李佳伟,时兆婷,侯英敏,等. 浸润性三阴性乳腺癌超声特征的临床、病理学及免疫组织化学基础[J]. 中国癌症杂志, 2019, 29(1): 37-44.

李佳伟, 时兆婷, 侯英敏. Clinicopathological and immunohistochemical basis for sonographic characteristics of triple-negative invasive breast cancer[J]. China Oncology, 2019, 29(1): 37-44.
李佳伟,时兆婷,侯英敏,等. 浸润性三阴性乳腺癌超声特征的临床、病理学及免疫组织化学基础[J]. 中国癌症杂志, 2019, 29(1): 37-44. DOI： 10.19401/j.cnki.1007-3639.2019.01.006.

李佳伟, 时兆婷, 侯英敏. Clinicopathological and immunohistochemical basis for sonographic characteristics of triple-negative invasive breast cancer[J]. China Oncology, 2019, 29(1): 37-44. DOI： 10.19401/j.cnki.1007-3639.2019.01.006.

摘要

背景与目的：三阴性乳腺癌（triple-negative breast cancer，TNBC）细胞增殖程度高，有明显的肿瘤异质性，缺乏针对性治疗药物，是恶性程度最高、预后最差的乳腺癌分子分型。超声是TNBC筛查和鉴别诊断的重要影像学方法之一。TNBC的超声图像特征表现出明显的变异性。该研究旨在探讨临床、病理学及免疫组织化学因素对TNBC超声图像特征的影响。方法：回顾性分析119例手术后经病理学检查证实的浸润性TNBC患者的术前超声图像、临床及病理学资料。2名具有5年以上临床经验的超声科医师对乳腺癌肿块超声图像进行特征分析与评估，评估内容包括肿块的方位、形态、边缘、内部回声、后方回声改变及钙化。按照患者年龄、肿瘤大小、病理组织学级别、Ki-67表达水平及人类表皮生长因子受体2（human epidermal growth factor receptor-2，HER2）评分将患者分组，以研究这些因素对TNBC超声图像特征的影响。结果：浸润性TNBC的超声特征与患者年龄、肿块大小、病理学分级、Ki-67表达水平及HER2评分相关：患者年龄影响肿块的后方回声（P=0.002），肿块大小影响肿块边缘是否毛刺成角（P=0.025），病理学分级影响肿块的形态（P=0.008）及后方回声（P=0.044），Ki-67表达影响肿块的形态（P=0.042）、边缘是否毛刺成角（P=0.005）及后方回声（P=0.005），HER2评分影响钙化的发生率（P=0.024）。结论：浸润性TNBC的超声声像图特征与患者年龄、肿块大小、病理学分级、Ki-67增殖水平及HER2评分有关。了解TNBC的超声特征及变异性相关的临床、病理学及免疫组织化学基础，可辅助早期诊断和提高诊断准确性。

Abstract

Background and purpose: While being recognized as a heterogeneous disease

triple-negative breast cancer (TNBC) is associated with aggressive biological property

a lack of targeted therapy and poor prognosis. Ultrasonography is one of the most important imaging methods for screening and differential diagnosis of TNBC. The sonographic features of TNBC show great variability. The primary objective of the present study was to evaluate the clinicopathological factors associated with sonographic appearances of invasive TNBC. Methods: With the ethical approval

119 patients who were pathologically confirmed as having invasive TNBC were retrospectively reviewed for ultrasound

clinical and pathological data. Two ultrasound physicians with at least 5 years’ experiences for breast diseases reviewed all ultrasound images and evaluated the sonographic features which included orientation

shape

margin

internal echo pattern

posterior acoustic pattern and calcification. Patients were grouped according to age

tumor size

histological grade

Ki-67 proliferation level and human epidermal growth factor receptor-2 (HER2) score to investigate the effects of these factors on the ultrasonographic characteristics of TNBC. The effects of clinicopathological factors on the sonographic features of TNBC were studied. Results: The sonographic features of TNBC were associated with patient age

tumor size

histological grade

Ki-67 proliferation level and HER2 score. Age of patient affected the posterior acoustic pattern (P=0.002). Tumor size affected the presence of angular or spiculated margin (P=0.025). Histological grade affected tumor shape (P=0.008) and posterior acoustic pattern (P=0.044). Ki-67 level affected the tumor shape (P=0.042)

presence of angular or spiculated margin (P=0.005) and posterior acoustic pattern (P=0.005). HER2 score affected the incidence of calcification inside TNBC (P=0.024). Conclusion: The sonographic features of TNBC are related to the patient’s age

tumor size

histological grade

Ki-67 proliferation level and HER2 score. Understanding the clinicopathological and immunohistochemical basis of sonographic characteristics and variability of TNBC is expected to assist early and accurate diagnosis of TNBC.

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