剪切波弹性成像定量参数对乳腺肿块良恶性的鉴别价值及其与组织Ki-67和C-erbB-2表达的关系研究

摘要 目的：探讨剪切波弹性成像（SWE）定量参数对乳腺肿块良恶性的鉴别价值，分析其与组织Ki-67和表皮生长因子受体2（C-erbB-2）表达的关系。方法：选择2021年1月至2022年1月于湖南省妇幼保健院超声医学科行乳腺SWE检查的106例乳腺肿块患者，根据术后或组织活检的病理检查结果分为恶性组59例和良性组47例。对比恶性组和良性组SWE参数的差异以及不同Ki-67和C-erbB-2表达乳腺癌病灶SWE参数的差异。Spearman分析乳腺癌病灶SWE参数与乳腺癌组织Ki-67和C-erbB-2表达的相关性。绘制受试者工作特征（ROC）曲线分析乳腺病灶SWE参数鉴别乳腺肿块良恶性的价值。结果：恶性组AE-max、Shell1 E _max 、Shell2 E _max 、Shell3 E _max 高于良性组（P＜0.05）。联合AE-max、Shell1 E _max 、Shell2 E _max 、Shell3 E _max 鉴别乳腺肿块良恶性的曲线下面积为0.841，高于单独参数鉴别的0.657、0.599、0.642、0.609（P＜0.05）。Ki-67阳性组、C-erbB-2阳性组AE-max、Shell1 E _max 、Shell2 E _max 、Shell3 E _max 高于阴性组（P＜0.05）。乳腺癌病灶AE-max、Shell1 E _max 、Shell2 E _max 、Shell3 E _max 与Ki-67和C-erbB-2表达均呈正相关（P＜0.05）。结论：乳腺恶性肿块与良性肿块的SWE参数存在明显差异，且与乳腺癌组织的Ki-67、C-erbB-2阳性表达有关，乳腺SWE检查有助于鉴别乳腺肿块良恶性。

Identification Value of Quantitative Parameters of Shear-Wave Elastography for Benign and Malignant Breast Masses and its Relationship Study with Tissue Expression of Ki-67 and C-erbB-2

ABSTRACT Objective: To investigate the identification value of quantitative parameters of shear-wave elastography (SWE) for benign and malignant breast masses, and to analyze the relationship between it and the expression of Ki-67 and epidermal growth factor receptor 2 (C-erbB-2). Methods:106 patients with breast masses who underwent breast SWE examination in department of Ultrasound medicine, Hunan Maternal and child Health Hospital from January 2021 to January 2022 were selected, and they were divided into malignant group with 59 cases and benign group with 47 cases according to postoperative or biopsy pathological findings. The difference of SWE parameters between malignant group and benign group and the difference of SWE parameters between breast cancer lesions with different Ki-67 and C-erbB-2 expression were compared. Spearman analyzed the correlation between SWE parameters of breast cancer lesions and the expression of Ki-67 and C-erbB-2 in breast cancer tissues. The receiver operating characteristic (ROC) curve was drawn to analyze the value of SWE parameters of breast lesions in differentiating benign and malignant breast masses. Results: AE-max, Shell1 E _max , Shell2 E _max , Shell3 E _max in malignant group were higher than those in benign group (P<0.05). The area under the curve of combining by AE-max, Shell1 E _max , Shell2 E _max , Shell3 E _max was 0.841, which is higher than 0.657, 0.599, 0.642 and 0.609 of single parameters (P<0.05). AE-max, Shell1 E _max , Shell2 E _max , Shell3 E _max in Ki-67 positive group and C-erbB-2 positive group were higher than those in negative group (P<0.05). The expressions of AE- max, Shell1 E _max , Shell2 E _max , Shell3 E _max were positively correlated with Ki-67 and C-erbB-2 in breast cancer lesions (P<0.05). Conclusion: There are significant differences in SWE parameters between malignant and benign breast masses, which are related to the positive expression of Ki-67 and C-erbB-2 in breast cancer. SWE examination is helpful to distinguish benign and malignant breast masses.