Study On Correlation Between Ultrasonographic Signs And Expression Of Multiple Immunohistochemical Factors In Invasive Ductal Carcinoma Of The Breast

Breast cancer is one of the most commonly diagnosed malignancies and the leading cause of cancer-related death among women worldwide.An estimated 1.67 million new diagnoses and 520,000 deaths from breast cancer occur each year.Clinically,estrogen receptor ER,progesterone receptor PR,human epidermal growth factor HER-2,nuclear protein KI67,P53,CK5/6,DNA topoisomerase Ⅱa TOPⅡa and other immunohistochemical indexes have been widely used to guide clinical treatment and evaluate the prognosis of patients.While the acquisition of immunohistochemical indicators is an invasive operation,ultrasound has become the preferred diagnostic method for breast diseases due to its advantages of non-invasive,cost-effective,sensitive and specific.But its accuracy can not meet the clinical needs.Therefore,many studies have focused on the correlation between ultrasound findings and immunohistochemical expression in breast cancer.Objective:To explore the correlation between ultrasonic signs of invasive ductal carcinoma of breast and the expression of ER,PR,HER-2,P53,KI67,TOPⅡa,CK5/6 and other immunohistochemical factors.By exploring the relationship between immunohistochemical factors and ultrasonic signs,the two can be better connected,in order to better guide clinical diagnosis and treatment.Methods:A total of 524 patients with primary invasive ductal carcinoma of the breast confirmed by surgical pathology in our hospital from January 2019 to December 2021 were retrospectively analyzed.Preoperative ultrasound examination was performed and standard ultrasound sonography was retained.Univariate analysis χ2 test and multivariate logistic regression were used to analyze the correlation between ultrasonographic signs and the expression of ER,PR,HER-2,P53,KI67,TOPⅡa and CK5/6 immunohistochemical factors,and logistic regression equation was constructed.Results:1.According to Logistic regression analysis,the irregular shape of the mass,reduced posterior echo and high echo halo had significant effects on the positive expression of ER,while the tumor edge polishing and abundant blood supply had significant effects on the negative expression of ER.The appearance of hyperechoic halo had significant effect on positive expression of PR,and the smooth margin and diameter>2cm had significant effect on negative expression of PR.Internal microcalcification had significant influence on positive expression of HER-2,while aspect ratio>1 had significant influence on negative expression of HER-2.Lymph node metastasis had significant effect on KI-67 high expression,and decreased posterior echo had significant effect on Ki-67 low expression.Internal microcalcification and lymph node metastasis had significant influence on P53 positive expression,while the presence of irregular mass and high echo halo had significant influence on P53 negative expression.The positive expression of CK5/6 was significantly affected by internal microcalcification,while the negative expression of CK5/6 was significantly affected by the presence of high echo halo.The positive expression of TOPⅡa was significantly affected by Mass diameter>2cm and lymph node metastasis,while the negative expression of TOPⅡa was significantly affected by reduced posterior echo.2.The above results were tested by the ROC curve,and the area under the curve was as follows:ER:0.855;PR:0.747;P53:0.703;KI67:0.693.;HER-2:0.683;TOPⅡa:0.681;CK5/6:0.608.Conclusions:There are some differences in the signs of invasive ductal carcinoma with different immunohistochemical expressions.These ultrasound signs can provide important reference for the diagnosis,clinical treatment and prognosis assessment of breast cancer,and further link imaging and pathology together.