Correlations of multimodal ultrasound parameters with Ki-67 and cytokeratin 5/6 in triple-negative breast cancer

Objective To analyze the correlations of multimodal ultrasound parameters with Ki-67 and cytokeratin 5/6 (CK5/6) in triple-negative breast cancer (TNBC).

Methods A retrospective analysis was conducted on 212 breast cancer patients in Jurong Hospital Affiliated to Jiangsu University and Jiangsu Provincial People′s Hospital from January 2017 to December 2023. The patients were divided into TNBC group (n=95) and non-TNBC group (n=117). Immunohistochemical staining was used to detect the expression of Ki-67 and CK5/6 in both groups, and the correlations of ultrasound parameters with Ki-67 and CK5/6 were analyzed.

Results In the TNBC group, the positive rates of CK5/6 and Ki-67 were 69.47% (66/95) and 75.79% (72/95) respectively, while in the non-TNBC group, the positive rates were 23.93% (28/117) and 14.53% (17/117) respectively, with significant between-group differences (P < 0.05). In the TNBC group, patients with high and low level of CK5/6 showed significant differences in maximum lesion diameter, morphology, margin, aspect ratio, presence of calcifications, posterior acoustic pattern, lymph node metastasis, and distant metastasis (P < 0.05); similarly, patients with high and low level of CK5/6 demonstrated significant differences in distribution, enhancement pattern, and perfusion defects (P < 0.05); patients with high and low level of Ki-67 also exhibited significant differences in maximum lesion diameter, morphology, margin, aspect ratio, presence of calcifications, posterior acoustic pattern, lymph node metastasis, and distant metastasis (P < 0.05); additionally, patients with high and low level of Ki-67 showed significant differences in the enhanced range, distribution, and enhancement pattern (P < 0.05). Multivariate analysis revealed that clear margin, calcifications, and enhanced range were independent influencing factors for CK5/6 positivity (P < 0.05), while enhancement pattern and enhanced range were independent influencing factors for Ki-67 positivity (P < 0.05).

Conclusion Ki-67 and CK5/6 have higher positive expression rates in TNBC patients, and multimodal ultrasound parameters are correlated with Ki-67 and CK5/6.