Tumor stiffness measured by shear wave elastography correlates with tumor hypoxia as well as histologic biomarkers in breast cancer.
Cancer Imaging
; 20(1): 85, 2020 Dec 01.
Article
en En
| MEDLINE
| ID: mdl-33256820
ABSTRACT
BACKGROUND:
Shear wave elastography (SWE) is an ultrasound technique for the noninvasive quantification of tissue stiffness. The hypoxic tumor microenvironment promotes tumor stiffness and is associated with poor prognosis in cancer. We aimed to investigate the correlation between tumor hypoxia and histologic biomarkers and tumor stiffness measured by SWE in breast cancer.METHODS:
From June 2016 to January 2018, 82 women with invasive breast cancer who underwent SWE before treatment were enrolled. Average tumor elasticity (Eaverage) and tumor-to-fat elasticity ratio (Eratio) were extracted from SWE. Immunohistochemical staining of glucose transporter 1 (GLUT1) was used to assess tumor hypoxia in breast cancer tissues and automated digital image analysis was performed to assess GLUT1 activities. Spearman correlation and logistic regression analyses were performed to identify associations between GLUT1 expression and SWE values, histologic biomarkers, and molecular subtypes. The Mann-Whitney U test, t test, or Kruskal-Wallis test was used to compare SWE values and histologic features according to the GLUT1 expression (≤the median vs > median).RESULTS:
Eaverage (r = 0.676) and Eratio (r = 0.411) correlated significantly with GLUT1 expression (both p < 0.001). Eaverage was significantly higher in cancers with estrogen receptor (ER)-, progesterone receptor (PR)-, Ki67+, and high-grade (p < 0.05). Eratio was higher in cancers with Ki67+, lymph node metastasis, and high-grade (p < 0.05). Cancers with high GLUT1 expression (>median) had higher Eaverage (mean, 85.4 kPa vs 125.5 kPa) and Eratio (mean, 11.7 vs 17.9), and more frequent ER- (21.7% vs 78.3%), PR- (26.4% vs 73.1%), Ki67+ (31.7%% vs 68.3%), human epidermal growth factor receptor 2 (HER2) + (25.0% vs 75.0%), high-grade (28.6% vs 71.4%), and HER2-overexpressing (25.0% vs 75.0%) and triple-negative (23.1% vs 76.9%) subtypes (p < 0.05). Multivariable analysis showed that Eaverage was independently associated with GLUT1 expression (p < 0.001).CONCLUSIONS:
Tumor stiffness on SWE is significantly correlated with tumor hypoxia as well as histologic biomarkers. In particular, Eaverage on SWE has independent prognostic significance for tumor hypoxia in the multivariable analysis and can potentially be used as a noninvasive imaging biomarker to predict prognosis and pretreatment risk stratification in breast cancer patients.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias de la Mama
/
Diagnóstico por Imagen de Elasticidad
/
Hipoxia Tumoral
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
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Aged
/
Aged80
/
Female
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Humans
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Middle aged
Idioma:
En
Revista:
Cancer Imaging
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
NEOPLASIAS
Año:
2020
Tipo del documento:
Article
País de afiliación:
Corea del Sur