The Correlation Study Of Ultrasonographic Features With Molecular Subtypes In Breast Cancer

ObjectiveIn order to study the correlation between ultrasonographic features and the expressionof ER, PR, C-erbB-2of breast cancer, to research the correlation between the characteristicsof ultrasound and molecular subtypes of breast cancer. Through the different ultrasono-graphic features to assess breast cancer’s molecular subtypes, for clinicians making themore reasonable, more effective and individual treatment plan and assessing prognosis, thusfurther promote ultrasound examination in the value of clinical diagnosis of breast cancer.MethodsCollected175breast cancer patients which were given surgical and confirmed bypathology in the88th Hospital of PLA from January2011to December2012, consist of174women and1man,175cases of breast malignant solid lesions, age from38to81years. Allthese patients acceptted ultrasonography but didn’t accept chemotherapy and radiotherapybefore operation. Ultrasonographic features of all lesions were recorded detailedly, thesefeatures included tumor size(with the maximum diameter line2cm as a border, the tumorsize is divided into two group, equal to or less than2cm for one group, big than2cm foranother group), margin(spiculation or not), boundary(clear or fuzzy), orientation(level orvertical growth), posterior echo types(acoustic shadowing or not), microcalcification, bloodflow(0～level I/level II～III) and signs of lymph node metastasis. After the operation,tumor was taken to department of pathology. Used the following4steps to make specimens:①take the focus of cancer②10%of formaldehyde fixed③paraffin embedded④3-4μmcontinuous slice. Then, the expression of ER、PR and C-erbB-2in tumor tissues weredetectted by immunohistochemical staining technique. According to the expression of thisthree molecular biology markers, breast cancer was categorized into3molecular subtypes:Luminal group [ER(+) or PR(+), with C-erbB-2(-) or (+)], C-erbB-2group [ER(-)、PR(-)and C-erbB-2(+)], triple-negative group [ER(-)、PR(-)、C-erbB-2(-)]. All data processed software by SPSS17.0, using χ2test, P≤0.05was considered statistically significant．Results(1)Tumor vertical growth, spiculate margin, posterior echo shadowing and less bloodflow were correlated with the positive expression of ER, PR(P＜0.05); The microcalcificat-ion and lymph node metastasis were correlated with the positive expression of C-erbB-2(P＜0.05). Tumor size and boundary had no significant correlation with the expression of ER,PR and C-erbB-2(P＞0.05).(2)Tumor margin, boundary, orientation, posterior echo types, microcalcification,lymph node metastasis and blood flow were correlated with the breast cancer’s molecularsubtypes. Triple-negative breast cancers were more likely to have the clear boundary, cir-cumscribed margin and no spiny, and were less associated with posterior acousticshadowing and microcalcification on ultrasonography, similar to benign tumor; Luminalgroup was more likely to have vertical growth, fuzzy boundary, spiculate margin, posteriorecho shadowing, these features are typical signs of malignant tumor; the C-erbB-2groupwas more likely to have lymph node metastasis and microcalcification.Conclusions(1)Breast cancer ultrasonographic features have correlation with the expression of ER,PR and C-erbB-2.(2)The different molecular subtypes of breast cancer have different ultrasonographicfeatures.(3)The ultrasonography of breast cancer have relatation with it’s molecular subtypes.(4)By ultrasound imaging combined with immunohistochemical technique, molecularsubtype could be preliminary estimated, malignant degree could be judged, and providemore accurate and more valuable diagnosis for clinicians, so that they could make the morereasonable, more effective and individual treatment plan and assess prognosis, thus furtherpromote ultrasound examination in the value of clinical diagnosis of breast cancer.