Prognostic value of ultrasound combined with mammography and PR and HER-2 status in high-grade and middle-low-grade ductal carcinoma in situ of the breast

doi:10.3877/cma.j.issn.1672-6448.2023.06.010

Abstract

Abstract:

Objective

To assess the predictive value of ultrasonography, mammography, and progesterone receptor (PR) and human epidermal growth factor 2 (HER-2) status for high-grade and middle-low-grade ductal carcinoma in situ (DCIS) of the breast.

Methods

A retrospective analysis was performed on 196 patients with breast DCIS confirmed by surgical pathology from January 2015 to December 2020 at Shanxi Tumor Hospital. All patients were examined by ultrasonography and mammography before operation, and had complete pathological data. According to postoperative pathological results, the patients were divided into a high-grade DCIS group (n=80) and a middle-low-grade DCIS group (n=116). Univariate analysis was used to compare the differences in imaging and immunohistochemical features of patients in the two groups. Factors with statistically significant differences in the univariate analysis were included in multivariate Logistic regression analysis to analyze the independent predictors of high-grade and middle-low-grade DCIS.

Results

The statistically significant parameters identified in the univariate analysis, such as mass on ultrasound, microcalcification on mammography, and estrogen receptor (ER), PR, and HER-2 status, were included in binary logistic regression for multivariate analysis. The results showed that mass (odds ratio [OR]=0.248, 95% confidence interval [CI]:0.109～0.562) and PR positivity (OR=0.230, 95%CI:0.057~0.931) were independent predictor of middle-low-grade DCIS. Microcalcification (OR=4.048,95%CI:1.736~9.440) and HER-2 positivity (OR=6.160, 95%CI:2.149~17.655) were identified to be independent predictor of high-grade DCIS.

Conclusions

Preoperative imaging examination and immunohistochemical determination of PR and HER-2 status have appreciated clinical value for the prediction of DCIS and the management and treatment of DCIS patients.

Key words: Ductal carcinoma?in?situ of the breast, Ultrasonography, Mammography, Immunohistochemistry

Zhuangzhuang Wu, Xiaojuan Zhang, Zehong Shi, yao Shi, Shaoling Yuan. Prognostic value of ultrasound combined with mammography and PR and HER-2 status in high-grade and middle-low-grade ductal carcinoma in situ of the breast[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 631-635.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2023.06.010

https://chaosheng.cma-cmc.com.cn/EN/Y2023/V20/I06/631

Figures/Tables 4

因素	高级别组（n=80）	中低级别组（n=116）	统计值	P值
年龄（岁， $x ¯$ ±s）	51.33±9.679	51.43±11.660	t'=-0.069	0.945
临床表现			χ²=0.012	0.914
肿块	66（82.5）	95（81.9）
其他	14（17.5）	21（18.1）
ER			χ²=47.569	＜0.001
阳性	40（50.0）	108（93.1）
阴性	40（50.0）	8（6.9）
PR			χ²=59.440	＜0.001
阳性	29（36.3）	103（88.8）
阴性	51（63.7）	13（11.2）
Her-2			χ²=51.380	＜0.001
阳性	43（53.8）	9（7.8）
阴性	37（46.3）	107（92.2）
超声表现			χ²=31.826	＜0.001
肿块型	21（26.3）	78（67.2）
非肿块型	59（73.8）	38（32.8）
X线表现			χ²=23.818	＜0.001
微钙化	60（75.0）	46（39.7）
无微钙化	20（25.0）	70（60.3）

因素	高级别组（n=80）	中低级别组（n=116）	统计值	P值
年龄（岁， $x ¯$ ±s）	51.33±9.679	51.43±11.660	t'=-0.069	0.945
临床表现			χ²=0.012	0.914
肿块	66（82.5）	95（81.9）
其他	14（17.5）	21（18.1）
ER			χ²=47.569	＜0.001
阳性	40（50.0）	108（93.1）
阴性	40（50.0）	8（6.9）
PR			χ²=59.440	＜0.001
阳性	29（36.3）	103（88.8）
阴性	51（63.7）	13（11.2）
Her-2			χ²=51.380	＜0.001
阳性	43（53.8）	9（7.8）
阴性	37（46.3）	107（92.2）
超声表现			χ²=31.826	＜0.001
肿块型	21（26.3）	78（67.2）
非肿块型	59（73.8）	38（32.8）
X线表现			χ²=23.818	＜0.001
微钙化	60（75.0）	46（39.7）
无微钙化	20（25.0）	70（60.3）

因素	变量名	变量赋值说明
ER	X₁	阳性=1，阴性=0
PR	X₂	阳性=1，阴性=0
Her-2	X₃	阳性=1，阴性=0
肿块型	X₄	肿块型=1，非肿块型=0
微钙化	X₅	有微钙化=1，无微钙化=0
病理结果	Y	高级别=1，中低级别=0

因素	β值	SE值	Waldχ²	P值	OR值	95%CI
ER	-0.488	0.818	0.356	0.551	0.614	0.123~3.053
PR	-1.468	0.713	4.427	0.039	0.230	0.057~0.931
Her-2	1.818	0.537	11.451	0.001	6.160	2.149~17.655
肿块型	-1.395	0.418	11.154	0.001	0.248	0.109~0.562
微钙化	1.398	0.432	10.473	0.001	4.048	1.736~9.440
常量	0.319	0.653	0.239	0.625	1.376

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