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乳腺癌超声造影血流动力学参数与VEGF、Flk-1/KDR表达相关性研究

作者:丁 波 李秀兰 肖 艳 许 丽 孙文兵 袁 丽

所属单位:湖北江汉油田总医院超声科(湖北 潜江 433100)

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摘要

目的探讨乳腺癌超声造影血流 动力学参数与VEGF、Flk-1/KDR表达的相 关性。方法 选取我院自2012年12月-2014 年12月收治的95例乳腺异常患者和25例 乳腺正常志愿者,分为正常组、单纯增生 组、非典型增生组、导管内原位癌组、 浸润性导管癌组,测定血管密度(MVD)及 VEGF、Flk-1/KDR的表达情况。结果 各组 峰值强度、曲线下面积及廓清时间有显 著性差异(P<0.001)。各组MVD值分别为 (18±5)、(20±5)、(30±4)、(31±8、 53±4),有显著性差异(P<0.001)。随 着患者病情加重,乳腺MVD也不断升 高;VEGF、Flk-1/KDR值从正常组到浸 润性导管癌组不断升高,有显著性差异 (P<0.001)。结论 乳腺癌进展过程中伴 随心血管形成及VEGF、Flk-1/KDR受体表 达,超声造影通过监测血管密度,可为 VEGF、Flk-1/KDR受体表达情况提供参 考。

Objective To explore the correlation of contrast-enhanced ultrasound of breast cancer hemodynamic parameters and VEGF, Flk-1/KDR expression. Methods 95 cases of abnormal breast patients and 25 normal breast volunteers in our hospital were selected from December 2012 to December 2014. They were divided into normal group, simple hyperplasia group, atypical hyperplasia group, intraductal carcinoma in situ and invasive ductal carcinoma group. The expression of MVD and VEGF and Flk-1/KDR were measured. Results There were significant differences in peak intensity, area under the curve and clearance time in each group (P<0.001). The MVD values of each group were (18±5), (20±5), (30±4), (31±8), (53±4), there was significant difference between different group (P<0.001). As the patient's condition worsened, the MVD of the breast increased, and the value of VEGF and Flk-1/KDR increased from the normal group to the invasive ductal carcinoma group, and there was a significant difference (P<0.001). Conclusion The progression of breast cancer is associated with cardiovascular formation and expression of VEGF and Flk-1/KDR receptors. By monitoring the density of blood vessels, contrast-enhanced ultrasound can provide reference for the expression of VEGF and Flk-1/KDR receptors.

【关键词】乳腺癌;超声造影;血流动力学;血管内皮细胞生长因子

【中图分类号】R737.9

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2018.09.015

前言

乳腺癌是发生在乳腺腺上皮组织的恶性肿瘤,乳腺癌中99%发生在 女性,男性仅占1%[1-2]。乳腺虽然并非参与人体生命活动的重要器官, 乳腺癌本身不会危及患者生命,但是乳腺周围却有许多血管以及淋巴 管,一旦癌细胞脱落,进入静脉或者淋巴管,很有可能发生转移。部 分癌细胞脱落后甚至可能在血管中形成癌栓,造成多处血栓栓塞,危 及生命。有研究[3-4]表明,自21世纪以来,乳腺癌的发病率以及死亡率 呈逐渐下降,这可能与我国大规模普查,早期发现疾病,将其控制于 癌前病变有关。但与发达国家相比,我国乳腺癌检出率仍然处于较低 水平,许多乳腺癌患者仅仅在出现症状或者乳腺癌晚期的时候才进行 体检而发现。此时,乳腺癌治疗往往达不到满意的效果。因此,全面 开展普查,并引进先进的检查技术,能有效发现早期病变,降低乳腺 癌发病率。目前,临床常用的普查方法为钼靶射片,但此方法对于早 期的乳腺病变敏感度较低,仍有待改进。有报道[5-6]指出,超声微血管 造影能有效发现乳腺癌早期血管增生情况,降低漏诊情况。为此,我 院对120名患者进行研究,现将报道如下。