彩色多普勒超声血流参数与Her2阳性乳腺癌组织PI3K Akt表达及临床预后的关系

doi:10.3969/j.issn.1006-6233.2025.08.020

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摘要目的:分析彩色多普勒超声血流参数与人表皮生长因子受体2(Her2)阳性乳腺癌组织磷脂酰肌醇3-激酶(PI3K)、蛋白激酶B(Akt)表达及临床预后的关系,评价其对预后的评估价值。方法:将2020年1月至2023年1月于本院就诊的103例Her2阳性乳腺癌患者为研究对象,按预后情况分为预后不良组(n=27)和预后良好组(n=76)。所有研究对象均行彩色多普勒超声检查获取血流参数[阻力指数(RI)、搏动指数(PI)、峰值流速(V_max)],并测定癌组织的PI3K、Akt表达。以Spearman相关分析PI、RI、V_max与Her2阳性乳腺癌组织PI3K、Akt表达或预后的相关性,以受试者特征工作(ROC)曲线分析PI、RI、V_max对预后的评估价值。结果:预后不良组的RI、PI、V_max值及PI3K、Akt表达阳性率高于预后良好组(P<0.05)。相关性分析显示,PI、RI、V_max与Her2阳性乳腺癌组织PI3K、Akt表达及不良预后均呈正相关(rRI=0.284, 0.206, 0.443; rPI=0.213, 0.244, 0.464; rV_max=0.245, 0.221, 0.355, P<0.05);ROC曲线显示,RI、PI、V_max及联合评估Her2阳性乳腺癌患者预后的曲线下面积(AUC)为0.919,灵敏度为88.89%,特异度为89.47%,联合评估效能优于各指标单独评估(P<0.05)。结论:PI、RI、V_max血流参数与Her2阳性乳腺癌患者的PI3K、Akt表达及不良预后呈正相关,通过分析上述血流参数可为患者的预后评估提供一定的参考价值,指导个性化治疗方案制定。

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	李小心
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关键词 ：人表皮生长因子受体2, 乳腺癌, 超声血流参数, 磷脂酰肌醇3-激酶, 蛋白激酶B

Abstract：Objective: To explore the relationship of color Doppler ultrasound blood flow parameters with expressions of tissue phosphatidylinositol 3-kinase (PI3K) and protein kinase B (Akt) and clinical prognosis in human epidermal growth factor receptor 2 (Her2)-positive breast cancer, and to evaluate the evaluation value on prognosis. Methods: Totally 103 patients with Her2-positive breast cancer who received treatment in the hospital from January 2020 to January 2023 were enrolled as study subjects. According to the prognosis status, the enrolled patients were divided into poor prognosis group (n=27) and good prognosis group (n=76). All subjects received color Doppler ultrasound examination to obtain blood flow parameters [resistance index (RI), pulsatility index (PI), peak flow rate (V_max)], and the expressions of PI3K and Akt in cancer tissues were determined. The correlation between PI, RI, V_max and Her2-positive breast cancer tissue PI3K and Akt expressions or prognosis was explored by Spearman correlation analysis. Receiver operating characteristic (ROC) curve was adopted to analyze the evaluation value of PI, RI and V_max on prognosis. Results: The RI, PI and V_max and positive expression rates of PI3K and Akt in the poor prognosis group were higher than those in the good prognosis group (P<0.05). Correlation analysis showed that PI, RI and V_max were positively correlated with Her2-positive breast cancer tissue PI3K expression and Akt expression and poor prognosis (rRI=0.284, 0.206, 0.443; rPI=0.213, 0.244, 0.464; rV_max=0.245, 0.221, 0.355, P<0.05). ROC curve suggested that the area under the curve (AUC), sensitivity and specificity of combination of RI, PI and V_max in evaluating the prognosis of patients with Her2-positive breast cancer were 0.919, 88.89% and 89.47%. The combined evaluation efficiency was better than that of each index alone (P<0.05). Conclusion: Blood flow parameters such as PI, RI and V_max are positively correlated with PI3K expression, Akt expression and poor prognosis in patients with Her2-positive breast cancer. Analyzing the above blood flow parameters can provide some reference value on the prognosis evaluation of patients, and guide the formulation of individualized treatment regimen.

Key words： Human epidermal growth factor receptor 2 Breast cancer Ultrasound blood flow parameters Phosphatidylinositol 3-kinase Protein kinase B

基金资助:2022年度省老年健康科研项目,(编号:LKM2022061)

通讯作者: 陶楚楚

引用本文:

李小心, 晋鑫, 王培, 陶楚楚. 彩色多普勒超声血流参数与Her2阳性乳腺癌组织PI3K Akt表达及临床预后的关系[J]. 河北医学, 2025, 31(8): 1343-1348.
LI Xiaoxin, JIN Xin, WANG Pei, et al. Relationship Between Color Doppler Ultrasonic Blood Flow Parameters and the Expression of PI3K and Akt in Her2-Positive Breast Cancer Tissues and Clinical Prognosis. HeBei Med, 2025, 31(8): 1343-1348.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.08.020 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I8/1343

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