乳腺癌超声造影定性及定量分析与p53表达的相关性研究

目的：探讨乳腺癌超声造影定性及定量特征与癌基因p53表达的相关性。方法：回顾性分析37例经手术及病理确诊的乳腺癌患者术前超声造影特征，术后对肿瘤标本用免疫组织学方法测定p53蛋白表达情况，并分析它与超声造影定性及定量特征之间的关系。结果：①该组乳腺癌肿块p53阳性表达率为43.2%（16/37）。②该组乳腺癌肿块的增强模式均以快速增强、高增强为主，与p53表达无关（P＞0.05）。③p53阳性表达的乳腺癌肿块出现灌注缺损、穿支血管的几率增加，两者间有相关性（P＜0.05）。④乳腺癌肿块超声造影时间-强度曲线定量分析表明，p53阳性表达的乳腺癌肿块峰值强度及曲线下面积增大，造影剂平均通过时间延长，与p53阴性表达的乳腺癌肿块之间均有显著性差异（P＜0.05）。结论：乳腺癌超声造影定性及定量指标与p53阳性表达之间存在一定的相关性，时间-强度曲线定量分析较定性分析更能精确的评价乳腺癌肿块的内部血供情况，从而为临床选择正确的治疗方案提供参考。

Qualitative and quantitative analysis and the relevance between contrast enhanced sonography of breast cancer and the expression of p53

Objective： To analyze relationship between contrast-enhanced ultrasound qualitative and quantitative features and expression of p53 in breast cancer. Methods： The contrast-enhanced ultrasound appearances of 37 breast carcinomas confirmed by pathology were analyzed. Immunohistochemieal method was used to test the expression of p53 in all the breast carcinomas, to analyze the relationship between it and the contrast-enhanced ultrasound appearances. Results： （1）The expres- sion rate of p53 were 43.2%（16/37）. （2）The main enhanced pattern of breast carcinomas was fast and markedly enhanced, which was not related to the expression of p53 （P〉0.05）. （3）The rate of perfusion defect or perforative vessels increased in breast carcinomas with p53 positive expression （P〈0.05）. （4）The qualitative and quantitative analysis from the intensity-time curve of contrast-enhanced ultrasound in breast cancer showed, the peak intensity and the area under the curve were bigger in breast carcinomas with p53 positive expression compared to the breast carcinomas with p53 negative expression （P〈0.05）. Conclusion： Qualitative and quantitative features of contrast-enhanced uhrasound were related to the expression of p53 in breast cancer in some extent. Quantitative analysis from intensity-time curve can give more accurate information about the blood supply of breast carcinoma, which will be helpful for selecting correct therapy method.