| BackgroundAccording to the latest global cancer data promulgated by CA in 2021,the new cases number of breast cancer(2.26 million)have surpassed lung cancer(2.2 million)became the largest number of cancer in the world.The cure rate of early breast cancer in clinic was as high as 90%,but most early cancer always without symptom,and patients often went to hospital at the middle or late stage,so it is particularly important to prevent and screen female breast cancer in China.Shear wave elastography(SWE)is based on the evaluation of the hardness of the lesion tissue and the surrounding normal tissue,it can quantitatively determine the hardness of the lesion.Recent studies have shown that SWE can effectively improve the accuracy of ultrasonic diagnosis of breast nodules and reduce the rate of surgery(or puncture)biopsy,so it is an excellent examination method.ObjectiveTo optimized and evaluated the diagnostic efficiency of each index(Emax,Emean,Eratio)of shear wave elastography.To explore the relationship between shear wave elastography parameters,2D ultrasound parameters and some pathological features of breast nodules.To explore the relationship between shear wave elastography parameters,2D ultrasound parameters and some molecular types of malignant nodules.Methods200 cases of breast nodules(100 cases of benign and 100 cases of malignant)patients who were treated by ultrasound and surgery in the First Affiliated Hospital of Xinxiang Medical College from 2016 to 2020 were taken as the research objects,and their two-dimensional ultrasound,shear wave elastography and nodule pathological parameters(including immunohistochemical results)were sorted and analyzed.Results1.The age,maximum diameter of nodules and SWE parameters of patients who with malignant nodules were significantly higher than those of patients with benign nodules(P< 0.05).At the same time,malignant nodules have a higher proportion of blurred edges,irregular shapes and punctate calcification,the difference is statistically significant(P <0.05).2.According to Emax,Emean and Eratio(SWE parameters),ROC curve about malignant nodules diagnosis were drawn,Emax AUC=0.989,sensitivity =98.0%,specificity = 98.0%;Emean AUC=0.967,sensitivity =88.0%,specificity = 96.0%;Eratio AUC=0.968,sensitivity =90.0%,specificity =99.0%.Emax has the largest area under the curve,which indicates that it has the best prediction effect.3.The Eratio value of ER negative patients is higher than those ER positive,and a higher proportion of ER negative patients have punctate calcification and lymphatic metastasis,the differences wwere statistically significant.(P < 0.05).A higher proportion of PR positive patients had irregular nodules,punctate calcification and lymphatic metastasis,the differences were statistically significant(P < 0.05).The maximum diameter of nodules and Eratio value of Her-2 positive patients were larger than those Her-2negative,and a higher proportion of Her-2 positive patients had punctate calcification,the differences were statistically significant(P < 0.05).The maximum diameter of nodules in patients with Ki-67 high expression was larger than those with Ki-67 low expression.Patients with high Ki-67 expression had a higher proportion of people with punctiform calcification,the difference was statistically significant(P < 0.05).The diameter,Emax,and Eratio of the five types of nodules[Luminal A-like,Luminal B-like,Her-2 positive(HR positive),Her-2 positive(HR negative),Basal-like] were significantly different(P< 0.05),but there were no significant difference between their Emean(P=0.511).ConclusionShear wave elastography parameters have good accuracy in the differentiation of benign and malignant nodules of the breast,and the diagnostic efficiency of Emax is better.The parameter Emax is related to the molecular classification of malignant nodules.This study has provided some preliminary references for the ultrasound diagnosis of breast cancer and its prognosis. |
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