摘要
目的探讨合成MRI定量参数直方图特征预测乳腺浸润性导管癌(IDC)患者人表皮生长因子受体2(HER2)表达状态的价值,并与ADC直方图特征的预测性能进行对比分析。方法前瞻性收集2020年1月至9月就诊于复旦大学附属肿瘤医院的195例乳腺病变患者,所有患者接受完整乳腺MR检查,包括合成MRI、DWI和动态对比增强MRI(DCE-MRI),所有手术标本经病理证实。采用PyRadiomics软件提取定量参数的直方图特征。采用独立样本t检验或Mann-Whitney U检验比较HER2阳性与HER2阴性乳腺IDC患者的合成MRI定量参数[T_(1)、T_(2)和质子密度(PD)]及ADC值的直方图特征差异。采用ROC的曲线下面积(AUC)评估变量预测HER2表达状态的预测性能。结果最终纳入122例乳腺IDC患者的122个病灶。其中31例为HER2阳性,91例为HER2阴性。HER2阳性与HER2阴性患者的临床、病理特征差异无统计学意义(P>0.05)。单因素分析结果显示HER2阳性与HER2阴性乳腺癌患者中PD中位数、PD平均值、PD峰度、T110th位数、T_(1)平均值、ADC值直方图的峰度差异具有统计学意义[PD中位数分别为79.80(75.90,83.90)ms、76.56(72.59,79.09)ms,Z=-3.46,P<0.01;PD平均值分别为78.89(74.80,84.01)ms、75.99(71.70,78.63)ms,Z=-2.61,P=0.01;PD峰度分别为6.45(3.45,7.54)、5.04(3.55,5.58),Z=-2.21,P=0.03;T110th位数分别为731.52(668.50,975.39)ms、726.51(588.38,852.19)ms,Z=-2.54,P=0.01;T_(1)平均值分别为1161.97(1063.56,1253.78)ms、1072.75(989.39,1154.04)ms,Z=-2.21,P=0.03;ADC值直方图的峰度分别为4.75(2.72,5.91)、3.82(2.69,4.39),Z=-2.43,P=0.02]。多因素分析结果显示PD中位数(P=0.004)与T_(1)平均值(P=0.004)是HER2表达状态的独立预测因素,两者构建的逻辑回归模型预测HER2表达状态的AUC为0.853(95%CI 0.779~0.926),灵敏度为71%,特异度为81%。ADC值直方图的峰度预测HER2表达状态的AUC为0.714(95%CI 0.611~0.817),灵敏度为45%,特异度为85%。DeLong检验提示二者的诊断效能差异具有统
Objective To evaluate the application value of the histogram features of quantitative parameters from synthetic MRI in predicting the expression of human epidermal growth factor receptor 2(HER2)in breast invasive ductal carcinoma(IDC)and to compare the prediction efficiency with that of ADC histogram parameters.Methods A total of 195 patients with breast lesions were prospectively enrolled in the Fudan University Cancer Hospital,from January 2020 to September 2020.All patients underwent preoperative synthetic MRI,DWI and dynamic contrast-enhanced MRI(DCE-MRI).All surgical specimens were confirmed by pathology.The histogram features of the quantitative parameters[T_(1),T_(2),and proton density(PD)]and ADC values were extracted by PyRadiomics software.Student t test or Mann-Whitney U test were used to compare the histogram characteristics of quantitative parameters(T_(1),T_(2),and PD)and ADC values between HER2-positive and HER2-negative breast cancers.The diagnostic efficacy of the variables in predicting HER2 expression state was evaluated using the area under curve(AUC)value of ROC.Results A total of 122 patients with breast IDC were included into analysis,with 31 of HER2-positive and 91 of HER2-negative.There was no significant difference in the clinicopathological characteristics between HER2-positive and HER2-negative breast IDC patients.Univariate analysis showed that there was statistically significant difference in PD-median[79.80(75.90,83.90)ms vs.76.56(72.59,79.09)ms,Z=-3.46,P<0.01],PD-mean[78.89(74.80,84.01)ms vs.75.99(71.70,78.63)ms,Z=-2.61,P=0.01],PD-Kurtosis[6.45(3.45,7.54)vs.5.04(3.55,5.58),Z=-2.21,P=0.03],T_(1)-10th percentile[731.52(668.50,975.39)ms vs.726.51(588.38,852.19)ms,Z=-2.54,P=0.01],T_(1)-mean[1161.97(1063.56,1253.78)ms vs.1072.75(989.39,1154.04)ms,Z=-2.21,P=0.03]and ADC-Kurtosis[4.75(2.72,5.91)vs.3.82(2.69,4.39),Z=-2.43,P=0.02]between HER2 positive and negative breast IDC patients.Multivariate analysis showed that PD-median(P=0.004)and T_(1)-mean(P=0.004)were independent risk factors for
作者
李芹
黄琰
杨孟
柴青焕
吴扑射
顾雅佳
Li Qin;Huang Yan;Yang Meng;Chai Qinghuan;Wu Puye;Gu Yajia(Department of Radiology,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;MR Research,GE Healthcare,Beijing 100176,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2021年第12期1294-1300,共7页
Chinese Journal of Radiology
基金
促进市级医院临床技能与临床创新三年行动计划-重大临床研究项目(SHDC2020CR2008A)。
关键词
乳腺肿瘤
磁共振成像
直方图
人表皮生长因子受体2
Breast neoplasms
Magnetic resonance imaging
Histogram
Human epithelial growth factor receptor 2
