[1]张春 禹雪 张永辉 付芬芬 张冬洁 谢凌铎 褚福涛 栗辰 王芹芹 徐硕 解云涛*.超声引导空芯针穿刺活检诊断乳腺癌激素受体状态的价值[J].中国微创外科杂志,2020,01(2):114-117.
　Zhang Chun,Yu Xue,Zhang Yonghui,et al.Diagnostic Value of Ultrasoundguided Core Needle Biopsy for Hormone Receptor States of Breast Cancer[J].Chinese Journal of Minimally Invasive Surgery,2020,01(2):114-117.
点击复制

超声引导空芯针穿刺活检诊断乳腺癌激素受体状态的价值()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2020年2期
页码:
114-117
栏目:
临床研究
出版日期:
2020-02-28

文章信息/Info

Title:
Diagnostic Value of Ultrasoundguided Core Needle Biopsy for Hormone Receptor States of Breast Cancer
作者:
张春 禹雪 张永辉 付芬芬 张冬洁 谢凌铎 褚福涛 栗辰 王芹芹 徐硕 解云涛*
（北京大学国际医院乳腺外科，北京102206）
Author(s):
Zhang Chun;  Yu Xue;  Zhang Yonghui;  et al.
Department of Breast Surgery, Peking University International Hospital, Beijing 102206, China
关键词:
超声引导空芯针穿刺活检; 乳腺癌; 雌激素受体; 孕激素受体
Keywords:
Ultrasoundguided core needle biopsy; Breast cancer; Estrogen receptor; Progesterone receptor
文献标志码:
A
摘要:
目的探讨超声引导空芯针穿刺活检（ultrasoundguided core needle biopsy，USCNB）检测乳腺癌激素受体状态的准确性。方法回顾性分析2016年9月~2019年4月127例未经过新辅助治疗的131个乳腺癌病灶。USCNB后7~46 d行乳腺癌手术。对比USCNB和手术切除组织的病理结果，包括雌激素受体（estrogen receptor，ER）、孕激素受体（progesterone receptor，PR）。结果USCNB均顺利完成。USCNB标本中ER阳性、阴性病灶分别为121个（121/131，924%）和10个(10/131，7.6%)，术后标本中分别为120个（120/131，91.6%）和11个（11/131，8.4%）（McNemar检验P=1000），两者诊断一致率为99.2%（130/131）（κ=0.948，P=0.000)。USCNB标本中PR阳性、阴性病灶分别为106个（809%，106/131）和25个(19.1%，25/131)，术后标本中分别为106个（80.9%，106/131）和25个（19.1%，25/131）（McNemar检验P=1.000），两者诊断一致率为95.4%（125/131）（κ=0.852，P=0.000)。USCNB与手术标本ER、PR表达性质均无统计学差异（McNemar检验P=1.000）。在表达比例方面，USCNB与手术标本ER阳性细胞所占比例差异无统计学意义［中位数90%（70%~90%）vs. 90%（80%~90%），Wilcoxon检验，Z=-1.804，P=0.071］。USCNB与手术标本PR阳性细胞所占比例差异无统计学意义［中位数60%（5%~90%）vs. 60%（5%~90%），Wilcoxon检验，Z=-0.592，P=0.554］。USCNB与手术标本ER、PR表达强弱差异无统计学意义（Wilcoxon检验，Z=-0.786、P=0.432；Z=-1.792，P=0.073）。结论USCNB可准确评价乳腺癌雌、孕激素受体表达状态，是术前评估乳腺癌激素受体表达的可靠方法。
Abstract:
ObjectiveTo discuss the accuracy of ultrasoundguided core needle biopsy (USCNB) in detecting the states of hormone receptors for breast cancer patients.MethodsWe retrospectively analyzed 127 patients with 131 breast cancer lesions without any neoadjuvant treatment between September 2016 and April 2019. Surgery was performed at 7-46 d after USCNB. The expression of estrogen receptor (ER) and progesterone receptor (PR) in USCNB was compared with that of surgical excision.ResultsUSCNB was successfully completed. ER positive lesions of USCNB were found in 121 lesions (121/131, 92.4%), while ER negative lesions were found in 10 lesions (10/131, 7.6%). For surgical specimen, there were 120 lesions (120/131, 91.6%) and 11 lesions (11/131, 8.4%), respectively. The McNemar test showed no significant difference (P=1.000) and the consistent rate was 99.2% (130/131) (κ=0.948, P=0.000). PR positive lesions of USCNB were found in 106 lesions (106/131, 809%), while PR negative lesions were found in 25 lesions (25/131, 19.1%). For surgical specimen, there were 106 lesions (106/131, 80.9%) and 25 lesions (25/131, 19.1%), respectively. The McNemar test showed no significant difference (P=1000), and the consistent rate was 95.4% (125/131) (κ=0.852, P=0.000). There were no significant differences in the qualitative expression of ER and PR between USCNB and surgical specimens. In the aspect of proportion, there was no significant difference for the proportion of ER positive cells between USCNB and surgical specimens ［median, 90% (70%-90%) vs. 90% (80%-90%), Wilcoxon test, Z=-1.804, P=0.071］. Neither was for the proportion of PR positive cells ［median, 60% (5%-90%) vs. 60% (5%-90%), Wilcoxon test,Z=-0.592, P=0.554］. For the comparison of intensity of ER and PR, the results showed no significant differences (Wilcoxon test, ER: Z=-0.786, P=0.432; PR: Z=-1.792, P=0.073). ConclusionsUSCNB can accurately evaluate the expression characteristics of estrogen and progesterone receptors in breast cancer. It is a reliable method for preoperative evaluation of the expression status of hormone receptors.

参考文献/References:

[1]Bray F,Ferlay J,Soerjomataram I,et al.Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA Cancer J Clin,2018,68(6):394-424.
[2]陈万青，李贺，孙可欣，等.2014年中国恶性肿瘤发病和死亡分析.中华肿瘤杂志,2018,40(1):5-13.
[3]中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2019年版).中国癌症杂志,2019，29(8):609-680.
[4]《乳腺癌雌、孕激素受体免疫组织化学检测指南》编写组.乳腺癌雌、孕激素受体免疫组织化学检测指南.中华病理学杂志,2015，44(4):237-239.
[5]张春，禹雪，张永辉，等.空芯针穿刺活检在乳腺导管内乳头状肿瘤中的诊断价值. 中国微创外科杂志,2019,19(9):800-802.
[6]Meattini I,Bicchierai G,Saieva C,et al.Impact of molecular subtypes classification concordance between preoperative core needle biopsy and surgical specimen on early breast cancer management: Singleinstitution experience and review of published literature.Eur J Surg Oncol,2017,43(4):642-648.
[7]陈圣，王也，柳伟伟，等.空心针穿刺活检对确定乳腺癌分子亚型的诊断价值.中华普通外科杂志,2017,32(1):49-53.
[8]Ough M,Velasco J,Hieken TJ.A comparative analysis of core needle biopsy and final excision for breast cancer: histology and marker expression.Am J Surg,2011,201(5):692-694.
[9]Nakamura R,Yamamoto N,Shiina N,et al.Impact of host and histopathological factors on the discrepancies in estrogen receptor, and progesterone receptor, and HER2 status between core needle biopsy and surgically excised tumors.Breast,2016,26:141-147.
[10]Robertson S,Ronnlund C,de Boniface J,et al.Retesting of predictive biomarkers on surgical breast cancer specimens is clinically relevant.Breast Cancer Res Treat,2019,174(3):795-805.
[11]Ensani F,Omranipour R,Jahanzad I,et al.The core needle and surgical biopsy concordance to detect estrogen,progesterone,and Her2 receptors in breast cancer:a comparative study.Iran J Pathol,2017,12(3):202-208.
[12]Petrau C,Clatot F,Cornic M,et al.Reliability of prognostic and predictive factors evaluated by needle core biopsies of large breast invasive tumors.Am J Clin Pathol,2015,144(4):555-562.
[13]Ozdemir A,Voyvoda NK,Gultekin S,et al.Can core biopsy be used instead of surgical biopsy in the diagnosis and prognostic factor analysis of breast carcinoma?Clin Breast Cancer,2007,7(10):791-795.
[14]王崇杰，王建丽，牟洁，等.乳腺癌术前核芯针穿刺检测ER、PR、CerbB2、Ki67的临床研究.中国现代普通外科进展,2011,14(7):517-520.
[15]Greer LT,Rosman M,Mylander WC,et al.Does breast tumor heterogeneity necessitate further immunohistochemical staining on surgical specimens?J Am Coll Surg,2013,216(2):239-251.
[16]Mann GB,Fahey VD,Feleppa F,et al.Reliance on hormone receptor assays of surgical specimens may compromise outcome in patients with breast cancer.J Clin Oncol,2005,23(22):5148-5154.

备注/Memo

备注/Memo:
*通讯作者，Email：xieyuntao@pkuih.edu.cn
更新日期/Last Update: 2020-05-16