广西医学

目的分析超声血流参数、超声弹性成像评分联合血浆miR⁃21表达水平对早期乳腺癌的诊断价值。方法选取120例疑似早期乳腺癌患者作为研究对象，依据病理组织学检查结果将其分为早期乳腺癌组（61例）与乳腺良性病变组（59例）。两组患者入院时均进行彩色多普勒超声及超声弹性成像检查，并采用实时荧光定量PCR检测血浆miR⁃21表达水平。比较两组患者基线资料、超声血流参数、超声弹性成像评分及血浆miR⁃21表达水平，采用二元Logistic回归模型分析超声血流参数、超声弹性成像评分及血浆miR⁃21表达水平与早期乳腺癌的关系，并绘制受试者工作特征（ROC）曲线评估超声血流参数、超声弹性成像评分及血浆miR⁃21表达水平对早期乳腺癌的诊断价值。结果早期乳腺癌组的舒张末期流速（EDV）、收缩期峰值血流速度（PSV）、最大血流速度（Vmax）、阻力指数（RI）、超声弹性成像评分及血浆miR⁃21表达水平高于乳腺良性病变组（P<0.05）。二元Logistic回归分析结果显示，高EDV、高PSV、高Vmax、高RI、高超声弹性成像评分及高血浆miR⁃21表达水平是早期乳腺癌发生的危险因素（P<0.05）。ROC曲线分析结果显示，EDV、PSV、Vmax、RI、超声弹性成像评分、血浆miR⁃21表达水平单独和联合诊断早期乳腺癌的曲线下面积（AUC）分别为0.770、0.773、0.766、0.746、0.765、0.758、0.912，联合诊断的AUC更大。结论超声血流参数、超声弹性成像评分及血浆miR⁃21表达水平与早期乳腺癌密切相关，三者可用于诊断早期乳腺癌，且联合诊断的效能更高。

Objective To analyze the diagnostic value of ultrasonic blood flow parameters and ultrasonic elastography score combined with plasma miR⁃21 expression on early breast cancer. Methods A total of 120 suspected patients with early breast cancer were selected as the research subjects, and they were assigned to early breast cancer group (61 cases) or breast benign lesions group (59 cases) according to pathological histological examination results. Color Doppler ultrasound and ultrasonic elastography examinations were conducted on patients of both groups at admission; simultaneously, real-time fluorescent quantitative PCR was adopted to detect plasma miR⁃21 expression. Baseline data, ultrasonic blood flow parameters, ultrasonic elastography score, and plasma miR⁃21 expression were compared between patients of the two groups. Binary Logistic regression model was employed to analyze relation of ultrasonic blood flow parameters, ultrasonic elastography score and plasma miR⁃21 expression with early breast cancer, and receiver operating characteristic (ROC) curve was plotted to evaluate diagnostic value of ultrasonic blood flow parameters, ultrasonic elastography score and plasma miR⁃21 expression on early breast cancer. Results The early breast cancer group exhibited higher end diastolic velocity (EDV), peak systolic velocity (PSV), maximum blood flow velocity (Vmax), resistance index (RI), ultrasonic elastography score and plasma miR⁃21 expression as compared with the breast benign lesions group (P<0.05). The results of binary Logistic regression analysis revealed that high EDV, high PSV, high Vmax, high RI, high ultrasonic elastography score and plasma miR⁃21 expression were the risk factors for the occurrence of early breast cancer (P<0.05). The results of ROC curve analysis indicated that areas under the curve (AUC) of EDV, PSV, Vmax, RI, ultrasonic elastography score, plasma miR⁃21 expression for alone and jointly diagnosing early breast cancer were 0.770, 0.773, 0.766, 0.746, 0.765, 0.758, and 0.912, respectively, and AUC of combined diagnosis was greater. Conclusion Ultrasonic blood flow parameters, ultrasonic elastography score and plasma miR⁃21 expression are closely related to early breast cancer, both of the three can be used to diagnose early breast cancer, and the combined diagnosis exerts higher efficiency.