Abstract:

Objective To investigate the correlation between the quantitative results, the semi-quantitative scores from ultrasound elastography and the distribution of myofibroblasts(MFS) in breast tumor,and to analyze the value of quantitative results and the semi-quantitative score from ultrasound elastography in the diagnosis of breast tumor. Methods Thirty eight patients with breast lesions underwent ultrasound elasticity examinations, tissue dispersion quantitative analysis technique was used to assess the 11 characteristic quantities and the corresponding strain ratios in all lesions,and the score of ultrasonic elastography was evaluated.38 cases were divided into benign and malignant group according to pathological diagnosis results.The expression levels of CD34 and α-SMA protein in breast tissue were examined by immunohistochemistry.The distribution patterns of MFS in breast tumor were analyzed.The correlation between the quantitative results, the semi-quantitative scores from ultrasound elastography and the distribution of MFS in breast tumor was studied. Results The expression level of CD34 in malignant group was significantly higher than that in benign group,while the expression level of α-SMA was significantly higher than that in benign group;the differences in the expression levels of CD34 and α-SMA between benign and malignant breast tumor patients were statistically significant(P<0.01). The masses observed in malignant group by elastography were shown in blue,while most of the masses in benign group were shown in green.There were statistically significant differences between two groups in elastography scores(P<0.05).There was a anegative correlation between the CD34 expression in tumor tissue and the score of ultrasound elastography (r=-0.423 7,P=0.027 3).There was a negative correlation between the CD34 expression and the score of ultrasound elastography(r=-0.423 7,P=0.027 3),while the positive correlation was found between the α-SMA expression and the score of ultrasound elastography(r=0.397 0,P=0.014 2).The CD34 expression was significantly correlated with the average relative strain value, entropy, area ratio of low-strain region, kurtosis, skewness and inverse difference moment (P<0.05).Among the 11 characteristics, CD34 was positively correlated with the average relative strain value(r=0.385 6,P=0.016 8) and entropy(r=0.380 5,P=0.018 5);CD34 was negatively correlated with area ratio of low-strain region(r=-0.351 7,P=0.030 4), kurtosis(r=-0.427 7,P=0.007 4), skewness(r=-0.394 6,P=0.014 2),inverse difference moment(r=-0.344 3,P=0.034 3), angular second moment(r=-0.484 9,P=0.002 0) and strain ration(r=-0.379 0,P=0.047 5);CD34 was not correlated with standard deviation, complexity and contrast(P>0.05). The α-SMA espression was positively correlated with kurtosis(r=0.356 9,P=0.027 8), skewness(r=0.323 0,P=0.047 9), area ratio of low-strain region(r=0.382 0,P=0.021 6)and strain ratio(r=0.403 3,P=0.012 0). Conclusion The features and its scores of ultrasound elastography are correlated with the distribution of MFS in breast tumor, suggesting that the ultrasound elastography is very informative and helpful in the diagnosis of breast tumor.

Key words: breast neoplasms, fibroblasts, ultrasound elastography imaging, tissue dispersion quantitative analysis