Abstract: BackgroundThe treatment and prognosis of breast cancer has close correlation with the expression of molecular biological markers.Objective　To investigate the correlation between the direct ultrasonic signs of breast infiltrating ductal carcinoma and the expression of estrogen receptor（ER） and progestrone receptor（PR）.Methods　A retrospective analysis was made on the clinical data of 109 patients with breast infiltrating ductal carcinoma who accorded with inclusion criteria and received the first diagnosis and underwent operation in the Affiliated Tumor Hospital of Xinjiang Medical University from December 2014 to April 2015.General data,immunohistochemical results（expression of ER and PR）,and ultrasound examination results（number,sites,size,stages of nidi and spicule signs,lobulated sign,internal microcalcification,posterior acoustic attenuation,aspect ratio,and Adler grade internal blood flow） were collected.Results　The number of patients with ER（+）,PR（+）,ER（-） and PR（-） was 75（68.8%）,67（61.5%）,34（31.2%） and 42（38.5%） respectively.There were 93 patients who had one nidus and 16 patients who had multiple nidi（the number of nidi ≥2）;48 patients had nidi on the right breast,and 61 patients had nidi on the left breast;the number of patients who had nidi in the out upper quadrant,the inner upper quadrant,the out lower quadrant,the inner lower quadrant was 51,27,16 and 15 respectively;the maximum diameter of nidus was 0.9-8.0 cm,and the average maximum diameter of nidus was（2.8±1.4） cm;the number of patients in T1,T2,T3 and T4 phrase was 28,62,19 and 0.Patients with ER（-）+PR（-） and patients without ER（-）+PR（-） were significantly different in the maximum diameter of nidus（P<0.05）.The direct ultrasonic signs of breast cancer showed that there were 90（82.6%）patients with Adler gradeⅡ-Ⅲ of internal blood flow,58（53.2%） patients who had lobulated sign,58（53.2%） patients who had internal microcalcification,49（45.0%）patients who had spicule signs,49（45.0%） patients who had posterior acoustic attenuation,and 41（37.6%） patients who had aspect ratio≥0.71.Spicule signs,lobulated sign,internal microcalcification and posterior acoustic attenuation had correlation with the expression of ER and PR（P<0.05）;aspect ratio and Adler grade of internal blood flow had mutual dependence from the expression of ER and PR（P>0.05）.Conclusion　Direct ultrasonic signs of breast infiltrating ductal carcinoma has correlation with the expression of ER and PR,and ultrasound can make pre-treatment assessment and prognostic evaluation of breast carcinoma.

Key words: Breast neoplasms, Ultrasonography, Receptors,estrogen, Progestins, Molecular biological markers

摘要： 背景　乳腺癌的治疗及预后与肿瘤的分子生物学指标表达密切相关。目的　探讨乳腺浸润性导管癌直接超声征象与分子生物学指标雌激素受体（ER）、孕激素受体（PR）表达之间的关系。方法　回顾性分析2014年12月—2015年4月首诊于新疆医科大学附属肿瘤医院并行手术的符合纳入标准的109例乳腺浸润性导管癌患者的临床资料。收集患者一般资料、免疫组化结果（ER、PR表达情况）、超声检查结果（病灶数量、病灶部位、病灶大小、分期、有无毛刺征、有无小分叶征、有无内部微钙化、有无后方回声衰减、纵横比、内部血流Adler分级）。结果　ER（+）75例（68.8%），PR（+）67例（61.5%），ER（-）34例（31.2%），PR（-）42例（38.5%）。单发病灶93例，多发病灶（病灶数量≥2个）16例；右乳48例，左乳61例；病灶位于外上象限51例，病灶位于内上象限27例，病灶位于外下象限16例，病灶位于内下象限15例；病灶最大径0.9~8.0 cm，平均病灶最大径（2.8±1.4）cm；T1期28例，T2期62例，T3期19例，T4期0例。ER（-）+PR（-）与非〔ER（-）+PR（-）〕患者病灶最大径比较，差异有统计学意义（P<0.05）。乳腺癌直接超声征象中，内部血流Adler分级Ⅱ~Ⅲ级90例（82.6%），小分叶征58例（53.2%），内部微钙化58例（53.2%），毛刺征49例（45.0%），后方回声衰减49例（45.0%），纵横比≥0.71 41例（37.6%）。毛刺征、小分叶征、内部微钙化、后方回声衰减与ER、PR表达之间存在关联性（P<0.05）；纵横比、内部血流Adler分级与ER、PR表达之间互相独立（P>0.05）。结论　乳腺浸润性导管癌直接超声征象与ER、PR的表达有一定相关性，超声可以对乳腺癌进行治疗前评估及预后评价。

关键词: 乳腺肿瘤, 超声检查, 受体,雌激素, 孕激素类, 分子生物学指标