摘要
目的探讨动态增强磁共振(DCE-MRI)血流动力学参数能否提供乳腺癌病理分子预后标志物的相关信息。方法回顾性分析该院经手术病理证实的乳腺癌76例,根据月经状态分为绝经期乳腺癌(47例)和非绝经期乳腺癌(29例)。根据免疫组化结果获得人类表皮生长因子受体-2(HER-2)、激素受体(HR)[雌激素受体(ER)或(和)孕激素受体(PR)阳性为激素受体(HR)表达阳性,ER和PR均为阴性为HR表达阴性]及细胞增殖抗原Ki-67表达情况。基于DSC-MRI感兴趣区获得相对强化、最大强化、最大相对强化、达峰时间、流入速率等血流动力学参数。结果在绝经期乳腺癌中,HR阳性者的达峰时间高于HR阴性者(P=0.038;诊断效能:AUC=0.71,敏感度为63.9%,特异度为90.9%)。在非绝经期乳腺癌中,HER-2阳性者的最大强化高于HER-2阴性者(P=0.044;诊断效能:AUC=0.75,敏感度为70.0%,特异度为75.0%)。达峰时间与Ki-67表达情况呈负相关(r=-0.356,P=0.002)。结论DCE-MRI血流动力学参数对预测乳腺癌病理分子存在一定价值,尤其达峰时间可在一定程度上预测乳腺癌Ki-67的表达情况。
Objective To investigate whether dynamic enhanced magnetic resonance(DCE-MRI)hemodynamic parameters can provide relevant information about the molecular prognostic markers of breast cancer pathology.Methods A retrospective analysis of 76 cases of breast cancer confirmed by surgery and pathology in our hospital were divided into menopausal breast cancer(47 cases)and non-menopausal breast cancer(29 cases)according to menstrual status.According to the results of immunohistochemistry,the expression of human epidermal growth factor receptor-2(HER-2),hormone receptor(HR)[positive estrogen receptor(ER)or progesterone receptor(PR)was positive HR expression,negative ER and PR were negative HR expression]and cell proliferation antigen Ki-67 were obtained.The relative enhancement,maximum enhancement,maximum relative enhancement,time to peak,inflow rate and other hemodynamic parameters based on the DSC-MRI region of interest were obtained.Results In menopausal breast cancer,the peak time of HR-positive patients was higher than that of HR-negative patients(P=0.038,diagnostic power:AUC=0.71,sensitivity was 63.9%,specificity was 90.9%).In non-menopausal breast cancer,the maximum enhancement of HER-2 positive patients was higher than that of HER-2 negative patients(P=0.044,diagnostic power:AUC=0.75,sensitivity was 70.0%,specificity was 75.0%).The peak time was negatively correlated with Ki-67 expression(r=-0.356,P=0.002).Conclusion DCE-MRI hemodynamic parameters have a certain value in predicting the pathological molecules of breast cancer,especially the TTP can predict the expression of Ki-67 in breast cancer to a certain extent.
作者
雷昊
董雨岚
吴涛
LEI Hao;DONG Yulan;WU Tao(Department of Radiology Center,the First Affiliated Hospital,Hengyang Medical College,University of South China,Hengyang,Hunan 421001,China;Department of Radiology,Affiliated Hospital of Xiangnan University,Chenzhou,Hunan 423099,China)
出处
《现代医药卫生》
2021年第24期4160-4164,共5页
Journal of Modern Medicine & Health
基金
2018-2019年度湖南省临床医疗技术创新引导计划项目(2018SK52004)。
