The Diagnostic Value Of Multi-modal Ultrasound Imaging In Triple Negative Breast Cancer

This study Aim to analyze the characteristics of ultrasound multi-modal imaging of triple-negative breast cancer,to explore the imaging characteristics and related pathological basis of triple-negative breast cancer,and to seek a non-invasive diagnosis method for preoperative diagnosis TNBC.In this study,354 breast cancer patients with pathologically confirmed and molecular typing from January 2019 to December 2020 in the Fifth Medical Center of PLA General Hospital,There were 354 cases,Among them,Triple-negative breast cancer(TNBC)68 cases,Non-Triple-negative breast cancer(Non-TNBC)286 cases.American College of Radiology Association(ACR,The Fifth edition)was used for routine acoustic analysis of the Breast Imaging Reporting and Data System(BI-RADS,2013)the technical terms are described.Among them,138 cases with intact sonography,TNBC 50 of them,Non-TNBC 88 example,Qualitative and quantitative analysis of these masses by ultrasonography,the description of qualitative analysis includes: perfusion uniformity,perfusion sequence,perfusion degree,perfusion boundary,whether there is perfusion defect,whether there is nourishing blood vessel.Qontra Xt Software(V3.06;Esaote,Italy)for qualitative analysis of contrast-enhanced ultrasound.Through fragment analysis of regions of interest,the time intensity curves were obtained to obtain the quantification parameters:perfusion Peak(Peak),Peak time(TP),rising slope(Sharpness),and area under the curve(AUC).Finally,100 cases(TNBC and Non-TNBC50 cases each)with complete multi-modal ultrasound data were selected to analyze the efficacy of their respective and tandem diagnosis.Two deputy chief physicians were independently analyzed by double-blind method,The inconsistent results of the analysis require the participation of a third chief physician to reach agreement.Immunohistochemical examination was used as gold standard.Different ultrasonic examination methods were analyzed to clarify TNBC relevant characteristics.Applying logical regression analysis to TNBC related features,To evaluate the diagnostic value of multi-modal ultrasound,SPSS(v26.0;IBM,American)Statistical software used to statistical methods Statistical analysis,Measured data are expressed as mean ± standard deviation,An independent sample t test was used for inter-group comparison.The counting data are expressed in terms of rate or composition ratio(%).chi-square test or Fisher’s exact probability method was used for comparison between groups.Comparison between groups of grade data was tested by Kruskal-Wallis rank sum.Based on Logistic regression analysis,Constructing the Work Characteristic Curve of Subjects(receiver operating characteristic,ROC),To analyze the diagnostic efficacy of multi-modal imaging technology.P < 0.05 was statistically significant.Almost all pathological types in TNBC group were invasive carcinoma(100%),Intraductal carcinoma in situ is rare(0%).Histopathological grade was mostly grade Ⅲ,Ki-67 index is high expression;Conventional two-dimensional ultrasound is mostly round or oval mass(57/68,83.8%;The edges are mostly differential or angular(34/68,50%;The internal echogenic part showed a cystic solid mass(10/68,14.7%;No micro-calcification within the mass,(44/68,65.7%;The posterior echo was less attenuated(11/68,16.2%);More in the rear echo enhancement(33/68,48.5%;Most of the TNBC showed abundant blood flow signals(53/68 of grade AdlerⅢ,77.9%);TNBC masses with moderate hardness(grade 4)(47/69,69.1%);The Peak perfusion Peak in TNBC group was(38.1±9.4)%,The area below the curve(AUC)is(2.73±1.38)(1/ s).TNBC showed more branching nourishing vessels in contrast-enhanced ultrasound.The above indexes were significantly different from Non-TNBC groups(P<0.05).Multi-mode ultrasound can significantly improve the accuracy of TNBC and provide important auxiliary information for clinical diagnosis,treatment and prognosis prediction of breast cancer.