Correlation between ER expression status and characteristics of high frequency ultrasound and SWE in HER2 positive breast cancer patients

ZHOU Yuwei; LIU Jingping; GONG Chunli; WANG Yang; LIU Ying

doi:10.19732/j.cnki.2096-6210.2022.01.007

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Correlation between ER expression status and characteristics of high frequency ultrasound and SWE in HER2 positive breast cancer patients

更新时间：2025-12-15

- Correlation between ER expression status and characteristics of high frequency ultrasound and SWE in HER2 positive breast cancer patients
- Vol. 31, Issue 1, Pages: 36-42(2022)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2022.01.007
  CLC：
- Published Online：28 February 2022，
  
  Published：28 February 2022
- 稿件说明：
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周宇微,刘景萍,公春丽,等. HER2阳性乳腺癌患者ER表达状态与高频超声及SWE特征的相关性研究[J]. 肿瘤影像学, 2022, 31(1): 36-42 https://doi.

org/10.19732/j.cnki.2096-6210.2022.01.007
周宇微,刘景萍,公春丽,等. HER2阳性乳腺癌患者ER表达状态与高频超声及SWE特征的相关性研究[J]. 肿瘤影像学, 2022, 31(1): 36-42 https://doi. DOI： 10.19732/j.cnki.2096-6210.2022.01.007.

org/10.19732/j.cnki.2096-6210.2022.01.007 DOI：

摘要

目的：

探讨人表皮生长因子受体2（human epidermal growth factor 2，HER2）表达阳性的乳腺癌患者，其雌激素受体（estrogen receptor，ER）表达状态与高频超声及剪切波弹性成像（shear wave elastography，SWE）图像特征的相关性。

方法：

选取2019年3月2020年12月唐山市人民医院乳腺外科就诊、有明确病理学检查结果，且HER2表达阳性患者136例。77例ER阴性为Ⅰ组，59例ER阳性为Ⅱ组。对上述病灶行高频超声及SWE检查，获得相应变量。分别比较各变量表达情况与分子分型间的差异，最后将上述有差异的变量，建立logistic回归模型，评价各变量诊断价值。以免疫组织化学检查为金标准，应用受试者工作特征（receiver operating characteristic，ROC）曲线分析比较各项指标。

结果：

高频超声结果显示Ⅰ组较Ⅱ组更易出现腋窝淋巴结转移（

＜0.05）。SWE显示Ⅰ组与Ⅱ组相比杨氏模量的最大值（

max

）、平均值（

mean

）、最小值（

min

）均较高（

＜0.05）。Logistic回归结果显示，淋巴结转移（OR=0.553，

=0.004）、

max

（OR=0.877，

=0.000）均是影响免疫组化结果的独立影响因素。淋巴结转移指标曲线下面积为0.602，

=0.042，95% CI 0.506~0.698，诊断灵敏度为59.3%，特异度为61.0%。

max

指标曲线下面积为0.910，

=0.000，95% CI 0.861~0.959，诊断灵敏度为96.6%，特异度为79.2%，阈值为124.335 kPa。

结论：

乳腺癌患者HER2表达阳性时，ER不同表达状态其腋窝淋巴结转移发生率及杨氏模量值存在明显不同，淋巴结是否转移和

max

值均为独立影响因素，其中

max

值诊断效能最佳，这将对临床治疗方案的选择具有重要的指导作用。

Abstract

Objective:

To study the correlation between estrogen receptor (ER) expression status and high frequency ultrasound and shear wave elastography (SWE) characteristics in human epidermal growth factor 2 (HER2) positive breast cancer patients.

Method:

A total of 136 patients were selected from Tang Shan peoples hospital in March 2019 to December 2020 in breast surgery

who had definite pathology and HER2 positive expression

including 77 patients with negative ER (group Ⅰ) and 59 patients with positive ER (group Ⅱ). High frequency ultrasound and SWE were performed to obtain the corresponding variables. The expression of each variable and the differences among the molecular typing were compared respectively. Finally

the above variables with differences were established Logistic regression model to evaluate the diagnostic value of each variable. Using the immunohistochemical results as the gold standard

the receiver operating characteristic (ROC) curve was used to analyze and compare the qualitative and quantitative indicators.

Results:

High frequency ultrasound: group Ⅰ are more likely to appear axillary lymph node metastasis than group Ⅱ (

＜0.05). SWE: group Ⅰ had higher maximum (

max

)

mean (

mean

)

minimum (

min

) value of Youngs modulus than group Ⅱ (

＜0.05). Logistic regression showed that lymph node metastasis (OR=0.553

=0.004) and

max

(OR=0.877

=0.000) were independent influencing factors for the results of immunohistochemistry. The area under the curve oflymph node metastasis ndicators was 0.602

=0.042

95% CI 0.506-0.698. The diagnostic sensitivity and specificity were 59.3% and 61.0%. The area under the

max

index curve was 0.910

=0.000

95% CI 0.861-0.959

diagnostic sensitivity was 96.6%

specificity was 79.2%

and cut-off value

was 124.335.

Conclusion:

When breast cancer patients expressed positive HER2

their incidence of axillary lymph node metastasis and Youngs modulus value were significantly different under different ER expression status

Both lymph node metastasis and

max

value were independent influencing factors

among which

max

value had the best diagnostic efficacy

which will play an important guiding role in the selection of clinical treatment plan.

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Related Institution

School of Medical Imaging, Shanxi Medical University

Department of Ultrasound Imaging, The First Hospital of Shanxi Medical University

Department of Ultrasonography, Nanjing Medical University First Hospital

Department of Breast Surgery, Nanjing Medical University First Hospital

Department of Pharmacy, Wuxi Maternal and Child Health Hospital Affiliated to Nanjing Medical University

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