CHEN Xiaoqin,WENG Xijin,SUN Haiqin, et al. The value of contrast-enhanced ultrasound combined with immunohistochemical markers in the prognostic evaluation of breast cancer[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2022, 52(4): 300-304.
Abstract：Objective: To investigate the characteristics of contrast-enhanced ultrasound (CEUS) related to the prognostic parameters of immunohistochemical markers in breast cancer, and to explore the value of CEUS in the prognosis evaluation of breast cancer. Methods: From January 2019 to December 2020, 150 patients with breast masses in Wenzhou Central Hospital were selected as subjects. All patients were examined by conventional ultrasound and contrast-enhanced ultrasound. The gold standard was the pathological diagnosis of surgical and/or puncture biopsy. The expressions of p53, Ki-67, estrogen receptor (ER) and progesterone receptor (PR) in
patients with breast cancer and benign breast masses were detected by immunohistochemical staining. The correlation between the positive expression of p53, Ki-67, ER and PR and the characteristics of contrast enhanced ultrasound in breast cancer patients were analyzed. Results: The sensitivity, specificity, accuracy, positive
predictive value and negative predictive value of contrast-enhanced ultrasound in the diagnosis of breast cancer were significantly higher than those of conventional ultrasound (P<0.05). The peak intensity of breast cancer patients was higher than that of benign breast masses (P<0.05), the time of onset enhancement, the time to peak and the peak extinction time of breast cancer patients were shorter than those of benign breast tumor patients(P<0.05). Blood perfusion defect in contrast-enhanced ultrasound images of breast cancer patients was positively correlated with the positive expression of p53 and Ki-67 (r=0.814, 0.839, P<0.05), but negatively correlated with the positive expression of ER and PR (r=-0.780, -0.769, P<0.05). The tumor range after contrast was larger than that before, and it was positively correlated with the negative expression of p53 and Ki-67 (r=-0.820, -0.841,P<0.05), but positively correlated with the positive expression of ER and PR (r=0.803, 0.785, P<0.05). The high peak enhancement was positively correlated with the positive expression of p53 and Ki-67 (r=0.789, 0.773,P<0.05), and it was negatively correlated with the positive expression of ER and PR (r=-0.754, -0.781, P<0.05).Conclusion: Contrast-enhanced ultrasound can improve the preoperative diagnostic accuracy of breast cancer.Some characteristics of CEUS are closely correlated with immunohistochemical markers of breast, reflecting the biological characteristics of breast cancer, which can be used as a reference indicator for preoperative noninvasive evaluation of prognosis of breast cancer.
