Objectives: Clarifying the expression of breast cancer receptor is the key to clinical treatment for breast cancer. This study aims to explore the correlation between X-ray and clinical characteristics of 4 molecular subtypes and their receptor types of breast cancer.
Methods: A total of 439 breast cancer patients who confirmed by pathology and performed X-ray examination were enrolled. The X-ray and clinical characteristics of 4 molecular subtypes and the expression of their receptors were analyzed.
Results: Luminal A type showed the highest proportion of spiculate masses, and the lowest calcification score, showing significant difference with other 3 subtypes (all P<0.001). The age in the human epidermal growth factor 2 (HER2) overexpression type group was older, the proportions of menopause, the calcification score, and the calcification score with 9-12 were higher, the sizes of the tumor were greater in the HER2 overexpression type group than those in the other 3 molecular subtype groups (age P<0.05, the rest P<0.01). The proportions of regular shape, edge indistinct, and high-grade invasive ductal carcinoma in the triple-negative type group were higher than those in the other 3 molecular subtype groups (all P<0.001). The proportions of non-menopausal patients and spiculate tumors in the estrogen receptor (ER) positive and/or progesterone receptor (PR) positive groups were higher than those in both ER and PR negative group (P<0.001 and P=0.001, respectively). The proportions of calcification fraction and high-grade invasive ductal carcinoma were higher, tumor sizes were greater in the HER2 positive group, Ki-67≥20% group than those in the HER2 negative group, Ki-67<20% group, respectively (P<0.001 or P<0.05, respectively).
Conclusions: Four molecular subtypes of breast cancer and their receptor expressions are correlated with X-ray and clinical characteristics, which can provide a basis for clinical diagnosis and treatment.
目的: 明确乳腺癌受体表达是乳腺癌临床治疗的关键。本研究旨在探索4种乳腺癌分子亚型及其受体表达的临床与X线特征。方法: 选取439例术前进行乳腺X线检查且术后经病理确诊的乳腺癌患者。分析乳腺癌不同受体表达患者的X线及临床特征。结果: Luminal A型出现毛刺肿块的比例最高，钙化分数均值最小，与其他亚型比较差异有统计学意义(均P<0.001)；人表皮生长因子受体2(human epidermal growth factor 2，HER2)过表达型的年龄最大，肿块直径最长，绝经后、钙化分数及钙化分数为9~12的比例最高，与其他亚型比较差异有统计学意义(年龄P<0.05，余均P<0.01)；三阴性型表现为肿块、肿块形状规则、边缘模糊及高级别浸润性导管癌的比例最高，与其他亚型比较差异均有统计学意义(均P<0.001)。雌激素受体(estrogen receptor，ER)阳性和/或孕激素受体(progesterone receptor，PR)阳性组未绝经和毛刺肿块的比例高于ER和PR全阴性组(分别P<0.001和P=0.001)；与HER2阴性组、Ki-67<20%组比较，HER2阳性组、Ki-67≥20%组的钙化分数和高级别浸润性导管癌的比例较高，肿块长径较长(P<0.001或P<0.05)。结论: 乳腺癌患者不同受体表达与X线和临床特征存在一定相关性，这可为临床诊断与治疗方案的选择提供一定依据。.
Keywords: X-ray characteristics; breast cancer; molecular subtype; receptor.