| Objective:To investigate the correlation between different characteristic features of automated breast volume scanner(ABVS)and immunohistochemical ER,PR,Her-2 and Ki-67 factors in breast invasive ductal carcinoma.Good treatment protocols and prognostic assessments provide reliable imaging information.Data and Methods: A total of 119 patients with invasive vascular carcinoma(IDC)were enrolled in our hospital from January 2017 to December 2017.A total of 125 lesions were identified.There were 113 cases with single lesion and 6 cases with 2 lesions.The patients were women between the ages of 32 and 82,with an average age of(53.1 ± 10.4)years.All lesions were operated on,and pathological diagnosis was confirmed.Using the Siemens Acuson S2000 ABVS system,the supine position was taken during the scan,the bilateral breasts were fully exposed,and the patient was calmly breathing to avoid artifacts caused by respiratory motion,and the position of the lesion was initially positioned by conventional two-dimensional ultrasound.After determining the approximate location of the lesion,switch the ABVS inspection mode so that the probe is in close contact with the surface of the breast to adjust the preset conditions of the instrument to the optimum.The median,medial,and lateral positions of the bilateral mammary glands were scanned from the bottom to the top.After the scan was completed,the images were saved and then transferred to a data processing system for analysis.Observed indicators included: mass size,margin,microcalcification,coronal "convergence sign" and pathologically confirmed lymph node metastasis.Judging criteria:(1)lumps size: the transverse diameter,longitudinal diameter,anteroposterior diameter of the mass,any diameter > 2cm,that is,the size of the mass is considered to be > 2cm.(2)edge burr / angle sign: 1 clear lumps can be seenfrom the mass to the surrounding tissue divergence of different lengths of radial line shadow or angulation.2 If there is no clear lumps,the edge of the mass can be seen to radiate radial lines.Any one of the above is considered to have a burr/angle.(3)Microcalcification: The image has microcalcification signs on any of the cross-section,longitudinal section,and coronal plane,that is,microcalcification is considered.(4)Convergence sign: The positive person showed a mid-high echogenic sign appearing in the ABVS coronal plane from the mass around the mass to the mass,while the negative one had no radial changes.The imaging data of all patients were analyzed by two diagnostic doctors of the same age in our department,and the results were finally obtained.(5)Lymph node metastasis: Histopathological examination of paraffin sections confirmed that the lymphoid tissue that was removed during the operation was positive for metastasis and negative for those without metastasis.Immunohistochemical criteria:(1)Microscopic examination revealed that brown or brown-yellow particles were the standard for judging positive cells.ER and PR were mainly found in the nucleus,positive cells were ≥10% positive,and positive cells were <10% negative.(2)HER-2 is mainly found in the cell membrane,(+++)is judged as positive,(-)(+)is judged as negative,(++)must be further tested by Fish;Fish positive is judged as positive,and Fish detection is positive.If it is negative,it is judged to be negative.(3)Ki-67 was mainly found in the nucleus.The positive number ≥14% was judged as high expression,and the positive cell number <14% was judged as low expression.The molecular basis of breast cancer determines biological behavior and imaging findings.Therefore,the study of various characteristic manifestations of ABVS in breast invasive ductal carcinoma has no correlation with ER,PR,Her-2 and Ki-67,and is the best clinical choice.Treatment protocols and prognostic assessments provide reliable imaging information.Research Result:1.Correlation between the maximum diameter of IDC mass and ER,PR,HER-2and Ki-67 Of the 125 lesions,61(61/125,48.8%)had a maximum diameter of >2 cm,and106(106/125,84.8%)had a high Ki-67 expression,with a maximum diameter of >2 cm and a high Ki-67.There were 58 expressions(58/61,95.1%).The chi-square test showed that the maximum diameter of the tumor was related to the expression of Ki-67,and the difference was statistically significant(P<0.05).2.IDC edge burr/angle sign,"convergence sign" and ER,PR,HER-2 and Ki-67correlation Of the 125 lesions,109 were marginal burrs/angular signs(109/125,87.2%),100 were ER positive(100/125,80%),and 90 were positive for PR(90/125,72%).92burrs/angeograms with ER-positive expression(92/109,84.4%),86 marginal burrs/angular signs and positive PR expression(86/109,78.9%),chi-square test showed marginal burrs The angle of angulation was related to the expression of ER and PR,and the difference was statistically significant(P<0.05).“Convergence sign”(76/125,60.8%),among which 70(70/77,90.9%)were positive for ER positive and 69 were positive for “convergence sign” and 69 positive for PR(69/ 76,90.1%),chi-square test showed that "convergence sign" was related to ER and PR expression,and the difference was statistically significant(P<0.05).3.Correlation between IDC microcalcification,lymph node metastasis and ER,PR,HER-2 and Ki-67 Of the 125 lesions,77 were microcalcifications(77/125,61.6%)and 84 were HER-2 positive(84/125,67.2%),of which 46 were IDC with microcalcification and HER-2positive(46/77,59.7%),chi-square test showed that microcalcification was related to Her-2 expression,and the difference was statistically significant(P<0.05).IDC was associated with lymph node metastasis in 66(66/125,52.8%),of which"39 patients with lymph node metastasis and Her-2 positive(39/66,59.1%),chi-square test showed lymph node metastasis The expression was related to Her-2 expression,and the difference was statistically significant(P<0.05).In Conclusion:1.The mass > 2cm is related to the expression of ki-67,suggesting a poor prognosis;2.The edge burr / angulation sign,"convergence sign" and ER,PR expression,suggesting sensitivity to endocrine therapy,prognosis is better than ER,PRnegative;3.The mass with microcalcification and lymph node metastasis is related to the expression of HER-2,suggesting that the tumor has a high degree of malignancy and a high recurrence rate;The characteristic features of "convergence sign",burr/angle sign,microcalcification,lymph node metastasis and mass >2cm in the ABVS coronal plane have important reference value for the diagnosis,treatment and prognosis evaluation ofinvasive ductal carcinoma of the breast. |
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