Study On The Relationship Between Quantitative Parameters Of Shear Wave Elastography And Clinicopathological,Immunohistochemical Characteristics In Breast Cancer

ObjectiveTo evaluate the correlation between quantitative parameters and tumor size,axillary lymph node status,histological grade,immunohistochemical profile and molecular subtype of breast cancer by using real-time shear wave elastography(SWE).MethodsCollecting 79 patients(mean age: 49.44±11.06 years)with breast cancer surgery or puncture biopsy in our hospital from August 2018 to August 2019,a total of 80 lesions,the postoperative pathology confirmed as breast cancer concurrent immunohistochemical examination.A routine ultrasound examination was performed first to obtain the two-dimensional grayscale image features and blood flow condition of the mass.Then,the quantitative parameters including mean elastography(Emean),maximum elastograpgy(Emax)and ratio of stiffness of the mass to stiffness of the surrounding gland tissue(Eratio)were obtained by shear wave elastography.Collecting pathological and immunohistochemical results of each breast cancer patient after surgery or biopsy,including estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(HER-2),tumor proliferator antigen(Ki-67),and molecular subtypes.In univariate analysis,the correlations between the quantitative parameters Emean,Emax,Eratio and mass size,histological grade,axillary lymph node status,ER,PR,HER-2,Ki-67,molecular subtypes were analyzed.The statisticallysignificant variables were further incorporated into the multivariate linear regression analysis to select the variables that had a significant effect on the quantitative parameters of the mass.ResultsThe larger the mass was,the greater the quantitative parameters was,the difference was statistically significant(P<0.05);the higher the quantitative parameters was in breast cancer with axillary lymph node metastasis than in axillary lymph node negative group(P<0.05);all the quantitative parameters of ER negative group were higher than those of positive group(P<0.05);all the quantitative parameters of PR negative group were higher than those of positive group(P <0.05);the quantitative parameters of HER-2 positive group were higher than those of negative group(P<0.05);Ki-67 expression was significantly positively correlated with Emean,Emax(P =0.031,P=0.018).Compared with other molecular subtypes,HER-2 overexpression breast cancer has the largest quantitative parameters,and the difference was statistically significant(P<0.05);in the intergroup comparison,the difference of Emax between HER-2overexpression breast cancer and Luminal A type and Lumianl B type was statistically significant(P=0.003,P=0.029).The difference of Emean between HER-2overexpression breast cancer and Luminal A type and Lumianl B type was statistically significant(P=0.002,P=0.010).The difference of Eratio between HER-2 overexpression breast cancer and Luminal A type and Lumianl B type was statistically significant(P=0.001,P=0.002).In the multivariate analysis,whether the mass size,axillary lymph node metastasis was independently correlated with the Emax of the mass(P=0.015,P=0.003),and the mass size was independently correlated with the Eratio(P=0.023).Conclusion1.In univariate analysis,tumor size and axillary lymph node status,ER status,PRstatus,HER-2 status,Ki-67 expression,molecular subtype had some impact on the stiffness of tumor.2.In multivariate analysis,the tumor size and axillary lymph node status were independently correlated with Emax;the tumor size is independently correlated with Eratio.3.Among the molecular subtypes,HER-2 overexpression tumor had the largest stiffness and Luminal A type had the least stiffness.There is a certain correlation between the clinicopathological,immunohistochemical characteristics of the tumor and the quantitative parameters of the shear wave elastography.Shear wave elastography may provide some basis for the treatment options and prognosis evaluation of breast cancer patients.